Between May 2017 and March 2022 a total of 16 free MSAP flaps were carried out for hand defect reconstruction. All donor sites were primarily closed. The reconstruction was successful in all cases. In one patient venous thrombosis occurred postoperatively, which was successfully revised. In two flaps, surgical hematoma evacuation was necessary within 24 hours after surgery. Complications or wound healing disorders at the donor site were not observed.