Emergency rectus abdominis free flap coverage of the hand

Summary A 42-year-old patient suffered a complete loss of soft tissue coverage over the carpus and metacarpus of her dominant hand. With exposure of vessels and nerves, and an open joint dislocation and finger amputations, immediate cover of the circumferential defect was achieved using a free rectus abdominis muscle flap covered with a skin graft. Healing was uneventful, and the flap bulkiness decreased within one-half year; debulking was not required. The final hand function was excellent. Emergency free flap coverage can salvage a hand; the rectus abdominis muscle flap transfer is safe, technically easy and expendable.