Versatility of the island forearm flap in the management of extensive skin defects of the hand.

SUMMARY: Even the most meticulously performed reconstructions of the hand are at risk of failure if appropriate soft tissue coverage has not been ensured. The radial forearm flap has been found useful in various applications involving soft tissue coverage of skin defects not only of the upper and lower extremities, but in other plastic reconstructive procedures as well. Most hand and microsurgeons will agree that the island radial forearm flap offers several important advantages for covering defects in the hand. The versatility of this flap offers valuable options for the surgeon as it may include bone, nerve or tendons to be used as a complex flap. Its reliability is attributed to the fact that since no anastomosis of vessels is required, the risk of thrombus formation at the anastomosis site is eliminated.