Abstract: Objective To explore the guiding effect of digital subtraction angiography （DSA） in selecting skin flaps for covering hand defects. Methods Retrospective analysis was made on six patients who had severe hand injury with the exposure of tendon and （or） bone. All the patients accepted DSA examination to determine the blood supply of forearm and hand, including radial artery, ulnar artery, perforating arteries, deep palmar arch and superficial palmar arch. According to the results of angiography, the vascular injury and the adjacent soft tissue conditions were evaluated. Then the reverse forearm island flap or distal free flap was selected to repair the wound. Results Four patients＇ radial artery, ulnar artery and palmar arehs were intact so that reverse forearm island flap was selected. The other two patients~ radial arteries were broken so that the free axial flap was selected. The flaps all survived completely. Conclusion DSA can clearly display the vasoganglion of the injured forearm and hand, detect the possible vascular injury, and effectively guide the selection of skin flap. The use of DSA improves the rationality of flap selection and the success rate of flap transplantation.

Key words: Digital subtraction angiography, Axial flap, Hand injury