TechniquesPedicled Split Hypogastric Flap (Superficial Inferior Epigastric Artery flap): A New Technique for Coverage of Nonadjacent Defects in the HandSabapathy, Shanmuganathan Raja MS, MCh, DNB; Senthilkumaran, Murugesan MS, MCh; Mohan, Monusha MS Author Information Department of Plastic, Hand, and Reconstructive Microsurgery, Ganga Hospital, Coimbatore, Tamil Nadu, India S.R.S. and M.S.: were involved in the clinical care of this patient. Our study was performed in accordance with and conforming to the Declaration of Helsinki. Conflict of Interest and Source of Funding: The authors report no conflicts of interest and no source of funding. Address correspondence and reprint requests to: Shanmuganathan Raja Sabapathy, MS, MCh, DNB, Department of Plastic, Hand, and Reconstructive Microsurgery, Ganga Hospital, 313, Mettupalayam Road, Coimbatore 641043, Tamil Nadu, India. E-mail: [email protected]. Techniques in Hand & Upper Extremity Surgery: September 2021 - Volume 25 - Issue 3 - p 191-196 doi: 10.1097/BTH.0000000000000331 Buy SDC Metrics Abstract Flap coverage of soft tissue defects on both surfaces of the hand or of nonadjacent defects in the hand is a challenge. Two flaps are needed or if a single flap is used, the intervening normal area or part of the flap must be deepithelialized or the flap tunneled under the normal bridge segment. We are presenting a new technique whereby the hypogastric flap based on the superficial inferior epigastric artery is split into 2 components for the coverage of such defects. The hypogastric flap is separated into a cutaneous component and an adipofascial component at the level of Scarpa fascia. The flaps are separated almost to the base to increase mobility. Now it can be used to cover 2 defects separated by 5 to 7 cm or for defects in the dorsum and the palm. We have used it in 3 patients, in 2 for the coverage of palmar and dorsal aspect of the hand and in one for the coverage of nonadjacent defects on the dorsum of the hand and distal forearm after postburn contracture release. We achieved good results with no flap-related complications. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.