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We describe a neurovascular island flap of forearm skin based on the radial artery at the wrist level with reversed arterial blood flow. The flap may cover almost any skin and soft tissue defect of the hand. The flap is drained via venous anastomosis between one of the forearm veins and a suitable vein of the hand. Sensation is provided through a microneural anastomosis of one of the sensitive nerves of the forearm to a corresponding nerve of the hand.
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