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The hand is exposed to many hazards, some of which result in loss of skin. Recovery of normal function depends on prompt replacement of the protective skin cover with skin graft. With rare exceptions a split-thickness graft is chosen for primary closure following acute trauma. The graft is easily cut, insures a stable bearing surface, "takes" well, and leaves minimal scarring at the donor site. Elective incisions in the hand prior to skin grafting should not cross flexion creases; disfiguring or disabling scars should be avoided in selecting a donor site; and where possible the simplest, most expeditious method of repair will usually insure the best functional result.
Cannon B, Murray JE. Reflections on Skin Grafting in Hand Repairs. JAMA. 1967;200(8):663–668. doi:10.1001/jama.1967.03120210049006
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