The medial upper arm fasciocutaneous flap. An alternative flap to cover palmar defects of hand and distal forearm.

Cutaneous defects on the palmar aspect of the hand and distal forearm can usually be covered by split skin grafts or, if the defect is small, by local flaps. However, for larger defects, especially in acute injuries where preservation of functional parts like nerves and tendons is in jeopardy and particularly when further surgery is contemplated, flap coverage becomes essential. Such a flap, besides being uniformly dependable and cosmetically acceptable, must have a reasonable position of immobilization, must be easy to nurse and must not hamper the daily routine of the patient. The medial upper arm fasciocutaneous flap, both distally based and proximally based appears, after a critical evaluation, to be the best answer to this problem short of a microvascular free flap.