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Choudhary et al. Plast Aesthet Res 2022;9:3 https://dx.doi.org/10.20517/2347-9264.2021.68 Page 5 of 6

Figure 6. Well healed donor area of leg, six weeks follow-up.

In our case, we used skin paddle based on perforator of posterior tibial vessels as a second free flap from a
single donor site. The distal end of the peroneal vessels was used for anastomosing vesesls of the skin paddle
without sacrificing another set of neck vessels for anastomosis.

Two lessons learned from this case:
(1) Harvesting bone and skin paddle as a separate free flap can save another potential flap donor area from
being wasted.
(2) The distal end of the peroneal vessels can be used as a recipient for a second free flap in vessel depleted
neck.

DECLARATIONS
Authors’ contributions
Drafting of the manuscript, important intellectual content, and technical support: Choudhary AN
Drafting of the manuscript and critical revision of the manuscript: Arora R
Drafting of the manuscript and critical revision of the manuscript for important intellectual content:
Mishra KS
Drafting of the manuscript and technical support: Nalla RK, Srivastava S
Drafting of the manuscript and supervision of the manuscript: Dewan AK

Availability of data and materials
Not applicable.

Financial support and sponsorship
None.

Conflicts of interest
All authors declared that there are no conflicts of interest.