Soft tissue coverage of the upper limb: A flap reconstruction overview

Different opinions about the reconstructive choice for upper limb are described in literature: advancement or rotation flaps, regional flaps and free flaps are the most common reconstructive options. Local and regional flaps can be used to cover small defects while large wounds require the use of free flaps or distant pedicled flaps. The coverage of large wounds opens a discussion about when to use free flaps and when distant pedicled flaps. This review will describe the different methods used for the coverage of soft tissues injuries affecting hand and/or forearm (excluding fingers). The aim is to show all flap reconstructive options in order to support the inexperienced surgeon during the management of traumatic injuries of the upper limb. •Traumatic injuries of the upper limbs can represent serious and challenging wounds.•The main challenge for a hand surgeon is to offer a stable, long lasting and aesthetically acceptable coverage.•Advancement or rotation flaps, regional flaps and free flaps are the most common reconstructive options of the upper limb.•Knowledge gleaned from the wide experience of surgeons is fundamental for the decision-making process.