Reconstruction of Dorsal Hand Burn Scars Using Microdissected Tailoring of the Free Anterolateral Thigh Flap

BACKGROUND: Currently, large defects of the dorsum and finger of the hand pose a great challenge to plastic surgeons. The most difficult problem is finding a suitable material that has a large area and a thin, reliable blood supply and can be tailored into many small flaps to cover the fingers. CASE SERIES: We present the cases of two patients admitted to our hospital with scars on the dorsal side of the hand after gas burns. The defects after scar release were reconstructed by microdissected tailoring of the free anterolateral thigh flap. Complete survival was achieved for all flaps, including the small flaps tailored for finger defects. The function and aesthetics of the hands significantly improved. The patients were satisfied after the pain, itching, and burning symptoms of the scar were relieved. CONCLUSION: Microdissected tailoring of the free anterolateral thigh flap is an ideal method for addressing hand defects. The microdissected tailoring technique allows the surgeon to construct a thin flap with a reliable blood supply from the perforator.