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Changes in reconstructive surgery due to new anatomical knowledge led us to summarize our experiences with the coverage of lower extremity soft tissue defects. Our preference is to use one stage pedicled flaps, which are more reliable than any other types of flaps. In the past 5 years we performed 72 flaps for replacing leg and foot soft tissue losses. Sixteen gastrocnemius muscle medial and lateral head pedicled flaps, 4 saphenous artery fasciocutaneous pedicled flaps, 14 soleus muscle pedicled flaps, 5 distally based hemisoleus muscle pedicled flaps, 22 distally based sural artery fasciocutaneous flaps, 6 dorsalis pedis fasciocutaneous pedicled flaps, 3 radial artery fasciocutaneous free flaps and 2 latissimus dorsi musculocutaneous free flaps were performed. Of the 72 flaps 63 healed completely. One sural artery flap necrotized, and 8 flaps had partial necrosis. Our 87.5 % complete healing rate suggests that pedicled flaps provide an excellent reconstruction of these defects. [ABSTRACT FROM AUTHOR]