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The hand is frequently affected area in high voltage electrical burn injury as an input or output sites. Therefore, proper treatment method should be applied in order to achive aesthetic and funtioning hand. To reconstruction of soft tissue defect in hand, a variety of treatment have been, but most are associated with drawbacks, such as limited range, limited application, long time surgery, 2nd stage surgery, large donor defect. The reverse dorsal digital and metacarpal island flaps use the dorsal skin of the digital or metacarpal areas, and they are based on the arterial branches anastomosing the volar and dorsal arterial networks. The series of 15 cases of reconstruction for soft tissue defect due to electrical burn in hand were reviewed. Most cases survived completely and we could gain satisfactory results. Advantages of these flaps are minimal defect in donor site, good reliability, short time and easy technique, versatile variation, usefulness in secondary reconstruction. In conclusion, our result suggested that the reverse dorsal digital and metacarpal artery island flap are very useful methods for reconstruction of soft tissue defect due to electrical burn in hand, functionally and aetheticallly.