To meet the special need of function and cosmetics, thin skin flap was used in repair of skin defect of hand. It was reported that 37 cases with skin defect of hand had been treated since 1992. Eight kinds of flaps were used, including sub-abdominal flap (in 8 cases), paraumbilical flap (in 8 cases), intercostal flap (in 5 cases), subclavicular flap (in 3 cases), thoracoacromial flap (in 3 cases), trigonum clavopectoral flap (in 4 cases), thenal flap (in 2 cases) and pedicled flap carrying superficial iliac circumflex artery (in 4 cases). All of defects were treated by one-stage operation. The size of the flaps used ranged from the minimum of 1.2 cm x 2.5 cm to the maximum of 10 cm x 16 cm. All the flaps were survived. The function and appearance of the hands were satisfactory. It was noted that thin skin flap had developed from conventional pedicled flap and subcorium vascular-net flap, but it was easy to perform and had a high rate of success. The principle in choosing the flap was also discussed. It was suggested that more attention should be concentrated to solve the problems encountered in the use of thin skin flap in the repair of skin defect.