Reconstruction of a large leg defect with a combined hatchet flap technique

The repair of lower leg defects, not amenable toprimary closure, may be challenging, since the skinat this level is scarcely elastic and difficult to mobilize.Local skin flaps are generally utilized only to restoremoderately sized losses, whereas grafting becomesa realistic choice in presence of larger wounds.We present the case of a 70-year-old man with awide defect on his right leg following the surgicalexcision of a squamous cell carcinoma. The woundwas successfully closed with a combination of threehatchet flaps. The various steps of the procedure andthe subsequent outcome are illustrated. Our choiceproved to be an easy, time-sparing, but effectivereconstructive solution for a large skin defectinvolving the leg.