Background and Objective

Among coverage options for skin defects on the hand and especially for reconstruction of the thumb, the flap of the first metacarpal dorsal artery that uses the skin of the back of the proximal phalanx of the index, is a well known technique providing good results.

Our aim is to carry out an actualization of this flap with a critical review of the literature, illustrated with cadaver dissection, and its application in some clinical cases of our own experience.

Methods

We conduct a review of the historical antecedents, the anatomy and a detailed description of the surgical technique by means of dissections in cadaver complemented with drawings and photos and the presentation of 4 successful clinical cases.

Results

We found 21 relevant articles complemented with 2 chapters of hand books. Based on these, a detailed documentation of the history, anatomy and surgical technique of the first metacarpal dorsal artery flap was made. On the part of the anatomical revision in corpses it was found that this flap has a vascular axis similar to that described in the literature, and on the part of the clinical application, we demostrate that is a secure and reproducible flap.

Conclusions

Taking into account the precise indications and a clear knowledge of the technique, the first metacarpal dorsal artery flap is a versatile and safe alternative for the management of skin defects in the hand.

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