Versatility of Dorsal Metacarpal Artery Flaps for Hand Burns.

Burns to the hands can be devastating injuries and early debridement and coverage can prevent these chronic problems. Reconstructive options for these defects include skin grafts, local, regional and distant flaps as well as free flaps. In this series we set out to demonstrate the versatility, durability and effectiveness of dorsal metacarpal artery flaps for primary soft tissue coverage This study involves a review of all consecutive patients who underwent acute soft tissue coverage using dorsal metacarpal artery flaps at our institution from December 2014 to December 2017. Four patients were identified, two underwent reverse dorsal metacarpal artery flaps and two others underwent first dorsal metacarpal artery flaps. Three patients were males and one female whose age ranged from 33-74 (mean 48 years old). Follow up ranged from 6 to 43 days. One of the four flaps had deepithelialization of the distal flap with loss of the most distal tip left to heal by secondary intention. The remainder of the flaps survived without incident. and a full thickness skin graft had 100% take onto the index finger donor site. At the final follow up, all flaps had healed completely and patients had return of almost complete active range of motion. Flaps based on the dorsal metacarpal arteries have been proven to be versatile and reliable methods for primary hand burn reconstruction.