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

The repair of lower leg defects, not amenable to primary closure, may be challenging, since the skin at this level is scarcely elastic and difficult to mobilize. Local skin flaps are generally utilized only to restore moderately sized losses, whereas grafting becomes a realistic choice in presence of larger wounds. We present the case of a 70-year-old man with a wide defect on his right leg following the surgical excision of a squamous cell carcinoma. The wound was successfully closed with a combination of three hatchet flaps. The various steps of the procedure and the subsequent outcome are illustrated. Our choice proved to be an easy, time-sparing, but effective reconstructive solution for a large skin defect involving the leg.