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Soft tissue reconstruction. Coverage of hand injuries.

The complexity of the hand necessitates careful assessment of an injury. Wound coverage requires careful appraisal of the tissue available for coverage and consideration of its functional and cosmetic aspects. The simplest yet most appropriate flap should be chosen. Local flaps can cover many wounds. Larger wounds may require significant debridement, which should be performed early using the pseudotumor technique. Free flap coverage is then indicated and should be completed within 3 days of injury if no extenuating circumstances exist.