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Page 4 of 10 Ciclamini et al. Plast Aesthet Res 2023;10:62 https://dx.doi.org/10.20517/2347-9264.2022.132

Table 1. Palm: reconstructive ladder and major aims
Size / Tool Sensibility Stability Stability and Like to Donor site
Wound sensibility like morbidity
Graftable Skin graft with or without dermal substitute/ healing by x
second intention
Small Primary closure or local flaps x x
Medium Pedicle flaps (radial, ulnar and posterior interosseous x x x
flaps, and other perforator-based flaps)
Free plantar flap x x x
Large anterolateral thigh flap (ALTF), the superficial
circumflex iliac artery perforator flap (SCIPF)
Lateral arm flap (LAF) and Dorsalis pedis flap x x
Gracilis muscle flap + graft x
Free fascial flaps (temporal,serratus, radial fascial) x x

Table 2. Dorsum: reconstructive ladder and major aims
Size / Tool Thin Loose Mobile Like to Donor site
Wound like morbidity
Graftable Skin graft with or without dermal substitute/ healing by second x
intention
Small Primary closure or local flaps x x x
Medium Pedicle flaps (radial, ulnar and posterior interosseous flaps, and other x x x
perforator-based flaps)
also at fascial plane
Large anterolateral thigh flap (ALTF), the superficial circumflex iliac artery x x
perforator flap (SCIPF)
Lateral arm flap (LAF) x x x x
Free fascial flaps (temporal,serratus, radial fascial) x x x x

Figure 1. Venous free flap for volar index soft tissue loss.