Soft-tissue coverage for upper extremity injuries

The injured upper extremity presents a reconstructive challenge to hand surgeons who must balance form with function. Any effort to provide soft-tissue coverage to the upper extremity should have well-defined preoperative goals and should take into account donor site morbidity, aesthetic acceptability, functional gains, and possible future operations. Today, the reconstructive arsenal is replete with skin grafts, allografts, local rotational flaps, and free tissue transfers of muscle, fascia, fat, skin, and combinations thereof. In an effort to further the knowledge of reconstructive surgeons and benefit patients with soft-tissue injuries of the upper extremity, this review will draw from the current body of literature to discuss the uses of many of the above options.