- In the reconstruction of the burned hand, each case must be carefully evaluated in the context of total patient care: only then can the proper procedure or management scheme be chosen. When the fundamental problem, is loss of surface coverage, it is usually necessary to add skin-by-skin grafts or flaps. Z-plastics and other local flaps, often do not provide enough tissue and present a higher complication rate when performed, in the context of scars contracture and increase tension, so that further stable tissue coverage is required (1-5). This paper suggests, the use of the hypothenar eminence as logical a donor site for pulp defects. The procedure is simple and produces an excellent end result. It works best where there is loss of fingertip skin but, when indicated, one can use this method to repair skin losses elsewhere in the hand.