BACKGROUND thigh-based, groin-based and lateral-thoracic-based flaps are available for microsurgical hand resurfacing –,which is the best? METHODS BestBETS methodology was used to systematically evaluate the advantages and disadvantages. PubMed, EMBASE and Cochrane databases were searched up until Sep 2020, using the search strategy: hand re-surfacing, free-flap, groin-flap, thigh-flap, lateral thoracic-flap, advantages, and disadvantages. RESULTS Overall, 31 papers were identified which were used to synthesize the discussion and conclusions. CONCLUSION thigh-based Anterolateral thigh (ALT) flaps offer the greatest versatility.