Dorsal Carpal Region Wound

Question

This large open wound is over the dorsal carpal region. What are the problems associated with the wound and what possible options for closure are there?

Answer

This is a large wound over a site of high motion with limited surrounding skin in the area. Closure by second-intention healing could be lengthy and lead to suboptimal function and cosmesis. There is no local closure or axial pattern flap available, so the best option would be to plan and place a full-thickness skin graft.