We have presented the highlights and the most recent innovations in our technique of applying abdominal pedicle flaps to the hand—a technique which we have modified progressively over the past twenty years. These changes have evolved as we have attempted to apply the principles of plastic surgery more fully in the transfer and shifting of skin in the treatment of extensive injuries of the hand. These technical innovations include the following:
1. Patterns are used for pedicle flaps. These patterns are laid out on the donor area to correspond to the recipient site and in making the patterns liberal use is made of points and darts of tissue at the borders of flap to break up undesirable straight-line sears.
2. Only enough subcutaneous fat should remain on pedicle flaps to meet the requirements of the planned reconstruction and flaps may safely be made as thin as desired.
3. Kirschner wires are useful as temporary fixation to maintain the functional position of the hand and to control pronation and supination of the forearm in relation to the abdominal pedicle flap.