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Abstract
The surgical management of ulcers in the lower extremity is traditionally conservative, and includes debridement and split thickness skin grafting. In the most intractable cases, however, this management is often not enough. In this report of three patients with non-healing ulcers of the lower extremity successfully treated with free muscle flaps, we advocate a more active surgical approach to the treatment of such conditions. This is also appropriate in patients for whom a microsurgical approach might not be considered because of advanced age, peripheral arterio-occlusive disease, or the presence of other risk factors.