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Figure 6. Upper left: penetrating injury of the distal lower limb dorsally to the medial ankle (after debridement), measuring 4 cm × 3.5 cm × 2.5 cm. Upper right: perforator flap measuring 12 cm × 4 cm was harvested, based on a perforator of the posterior tibial artery. Another more distally located perforator was found but was ligated due to the close proximity of the wound. Lower left: the proximal tip of the flap was de-epithelized to fill the dead space. Lower right: the flap was rotated 180° and filled the defect