Design of various flaps in first web space. A, Proximally based flaps: based on first dorsal metacarpal artery and branches. Island flap pedicle includes first dorsal metacarpal artery and its branches, first dorsal interosseous fascia, subcutaneous tissue and veins, and radial nerve branches and accompanying artery. B, Distally based flap: based on one of distal perforators (arrows). C, Double flap from web space: fascial flap based on first dorsal metacarpal artery (marked in drawing by hook) and cutaneous flap based on artery accompanying radial nerve (green line).