Abstract: Objective To observe the effect of radial transverse free flaps with the palmar branch of the radial artery and the thoracic and abdominal perforator flap for the treatment of hand wound tissue, and to explore the ideal surgical method for the treatment of hand wound tissue, and provide a reference for clinical practice. Methods Total 82 cases of hand trauma patients were collected from May, 2016 to May, 2017 in the emergency department. According to the random number table method, the control group (41 cases) and the observation group (41 cases) were used to repair the free flap of the transverse branch of the wrist and the palmar branch of the radial artery, and the SPSS 21.0 system was used for the data. The operation time, bleeding volume, flap survival, finger reconstruction function and patient satisfaction were compared between the two groups. Results The operation time of the observation group (90.7±20.1) min was shorter than that of the control group (134.9±24.3) min, the difference was significant (t=8.974, P<0.05), and the amount of bleeding (94.2±9.3) ml in the observation group was similar to that of the control group (97.7±6.8) ml, the difference was not significant (t=1.945, P>0.05), and the survival rate (100.0%) of the skin flap in the observation group was slightly higher than that of the control group (97.6%) the difference was not significant (P>0.05); the good rate of finger reconstruction (92.7%) in the observation group was higher than that of the control group (80.5%), and the difference was significant (χ²=2.625, P<0.05); the patient satisfaction of the observation group (97.6%) was higher than that of the control group (80.5%), and the difference was significant (χ²=4.493, P<0.05). Conclusion The transverse radial artery forearm flap for the repair of hand wound tissue is ideal, the operation time is short, the function of finger reengineering is good, the patient's satisfaction is high, and it is worthy of clinical application.