Two cases of open wounds of the palm which have been resurfaced with microvascular "free" tissue transfers are presented. The first of these cases is that of a pressman who sustained a severe crush injury of the hand. Soft tissue was lost both dorsally and palmarly. Both areas required flap coverage. The final procedure was a radial forearm flap from the opposite upper extremity. This flap resulted in good coverage with a thin flap for the very important tactile area of the palm.

The second case was that of a machinist who sustained a large full thickness burn of the palm. This resulted in thick hypertrophic scarring of the palm. After a year of followup and no spontaneous improvement, the palm was resurfaced with a composite web space microvascular transfer from the dorsum of the foot. The web spaces were reconstructed with like tissue resulting in a very significant improvement in the resultant scarring and function of the hand. An excellent result in a young hispanic working man is presented.

In summary, two cases of large wounds of the palm requiring flap transfers are presented. The first illustrates salvage of the severely crushed hand with a very good functional result and a pliable smooth palm allowing for a return to manuel labor. The second illustrates the desirability of coverage with like tissue when feasible with an example of recreation of the web spaces of the hand with those of the foot.