Hand and finger soft tissue defects have always represented a surgical challenge at any accident and emergency department. Techniques may vary from just direct closure of the wound to free tissue transfer. Knowledge of the main locoregional hand flaps is paramount to solve most of the soft tissue defects at this level. Flaps vary depending on their blood supply and design. Their vascularity might be at random, they can be pedicled with anterograde or reversed flow or they can rely on simple or complex free tissue transfer whose blood flow depends on vascular anastomosis. This article reviews all the main soft tissue local or locoregional reconstructive techniques for hands and fingers.
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