Purpose Surgical approaches in hand surgery are varied and there is considerable debate regarding the best incision types. Skoog described his approach for Dupuytren’s contracture, whilst Bruner’s incisions are widely utilised for many conditions. Trauma demands a degree of adaptability as traditional incision patterns may not always be appropriate. We discuss here the different incision patterns for hand surgery. Methodology A literature review was completed. Local hand surgeons in South Australia were interviewed about their preferences on surgical incisions. Photos of lacerations were shown with surgeons marking their planned incisions. Results There are few articles tackling this complex area. Most surgeons agreed on incision preference. There was variability in marked incision patterns. The advantages and disadvantages of each incision type were summarised. Conclusion The optimal incision for hand surgery is likely to remain a matter of surgeon preference, and we have presented here a thorough review on the advantages and disadvantages of the different options. Increased knowledge of the variety of skin incisions for hand surgery, their advantages and disadvantages and applications for each can result in safer hand surgery with better functional and cosmetic outcomes.