Freestyle Local Island Pedicle Flap in Lower Leg Reconstruction.

The freestyle local perforator flap is an advanced version of the conventional island pedicle flap. Intramuscular dissection can provide a longer pedicle, which allows restoration of defects that are future from the donor site. Without microsurgery, the flap can be either rotated or advanced toward the defect, making it particularly useful for reconstructing soft tissue defects in the lower third of the leg. Careful preoperative design with vessel mapping, skillful intramuscular dissection of the pedicle, and a well-considered backup plan in case of unexpected difficulty are crucial for freestyle local perforator flaps to be successful.