Dr J Brunner’s work stemmed from his experience as a military surgeon mostly operating on hand injuries resulting from factories. He reported the ideal digital incision would allow for maximal exposure of nerves/vessels and tendons without compromising sensate, vascular skin flaps. The Brunner excision was revolutionised in 1967 describing a ‘zig zag’ incision between flexion creases allowing for good visualisation to structures, preservation of neurovascular bundles and viability of skin flap. This remains one of the most used volar hand incisions to date. Dancey et al in 2008 pitched a modified Brunner incision creating small flaps of varying size in existing skin creases. These flaps were marked on either ulnar or radial side of the finger when the finger is placed in a position of maximal flexion. This created V shaped flaps once the finger was in an extended position. The flaps were different sizes to reflect the difference in range of movement at the DIPJ and PIPJ. This can be used for both trauma and elective hand surgery cases. Saun et al in 2020, dubbed the volar oblique incision starting proximal to the DIPJ medial to the neurovascular bundle. This extended obliquely along the volar surface of the digit across the PIPJ ceasing just distal to the MCPJ preserving the neurovascular bundle laterally. The predominate use was for adequate exposure of PIPJ with advantages such as lower incidence of flexion contracture and better scarring outcomes. Thus, the perfect incision is based on core principles of adequate exposure and preservation of neurovascular structures without compromising flap integrity.