Objective To explore the method and clinical effect of repairing large soft tissue defects on the palm and back of the hand with the pedicled over and out bdominal flap designed by a"S"shaped incision.Methods A retrospective analysis was conducted on 8 patients with extensive soft tissue defects of the palm and back of the hand,bone and tendon exposure,who were admitted from January 2020 to May 2023.Designed an S-shaped incision on the same side of the affected limb's abdomen to form two tongue shaped flaps,covered and repaired the wounds on the palmar and dorsal sides respectively.The donor area was directly sutured without skin grafting.Results All patients were followed up for a period of 12-72 months.All the flaps of 8 patients with over and out abdominal flaps survived well,including 1 case of postoperative infection of the flap.After 2 weeks of wound dressing change,the infection was controlled,and no flap necrosis was found.This case also suffered from ulnar nerve rupture,defect,and flexor tendon injury caused by trauma,resulted in poor postoperative functional recovery.The remaining 7 patients had good skin flap healing and functional recovery.Conclusion The pedicled over and out abdominal flap designed by a"S"shaped incision,as a type of random flap,is used to repair large soft tissue defects on the palm and back of the hand.The abdominal donor area has a large resection area,is not limited by fixed nutrient vessels,and the donor area is concealed.It is a practical,effective,and easy to carry out surgical method.
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