Distal flap plastic surgeries are employed when the defect coverage cannot be accomplished sufficiently through local or regional actions. In these cases it is necessary to use a distantly located tissue unit. This tissue flap is prepared in such a way, that the nourishing blood vessels are preserved and left intact in place, so that it can be efficiently perfused. Commonly, the flap is sewn on the defect and nourished from its own vessels for a period of 2-3 weeks before it is completely divided. In this time new blood vessels in the new location will build within the flap. Typical examples of distal flaps are the groin and cross leg flap. A disadvantage of these procedures is that the patient should be immobilized at the level of the affected extremity (hand, foot) for a specific time period lasting from two to three weeks, time needed for the flap to be fully integrated. Only then, can the flap be divided and further molded in place. Free flap microsurgically tissue transfers lack the disadvantage of a long time immobilization since the supra-regional or distally located transferred tissue unit be directly connected with the recipients blood supply. Our clinic emphasizes on soft tissue coverage by means of tissue tranfers all under microsurgically methods. As a center for Plastic Reconstructive Microsurgery in Berlin we are in the position to offer all procedures concerning soft tissue coverage (including hand surgery ), in Berlin and beyond.