Abstract
Complicated hand and wrist defects require durable and pliable tissues which are offered by flaps, instead of skin grafts. Various dorsoulnar flap options have been used in the regional flap armamentarium of the upper limb. Poor venous drainage may be a considerable handicap when moderate to large skin paddle dorsoulnar flaps are used. In the present case, we aimed to reduce the risk of necrosis by supercharging the dorsoulnar island flap. The current literature regarding dorsoulnar island flap has also been reviewed withfocuson this flap. This technique has successfully been used for a complex wrist defect in a 48-year-old man. Postoperative follow up was one year. The flap survived completely with perfect hand function. We think this modification can prevent possible venous stress in the pedicled and free dorsoulnar flaps by obtaining extravenous drainage. The method is simple, does not need sophisticated microsurgical procedure and longer operative time.