A social stigma as a favorable reconstructive option: Implications on donor site selection

Self mutilation poses a stigmatizing concern for a repentant patient and yield to social eschewing. Many of them undergo surgery for treatment of such scars. In this report, we present a case in whom we elected a self mutilation scar bearing dorsal surface of the forearm as a flap donor site for resurfacing a defect on the back of the first web space. Patient had been referred hand injury by shotgun.  While that particular flap (posterior interosseous flap) is not our first choice in such cases, in the face of this preexisting condition we stepped out of our comfort zone for the sake of treating both conditions in one sitting. We think that if a patient with stigmatizing scars presents in need of surgical reconstruction, scarred sites should be chosen as donor sites whenever possible. Therefore, when the hand defects reconstructed, simultaneously, an acceptable single longitudinal scar can be leaved on the forearm instead unpleasant transvers scars.