The pedicled fillet flap concept has been successfully applied in both
the upper and lower extremities for the treatment of difficult wounds
. However, in cases of complete extremity amputation, the transfer of
pedicled flaps from the amputated part is not possible. In such instan
ces, we have designed free-fillet flaps from the amputated limb to pro
vide wound coverage when replantation of the amputated part was contra
indicated. This technique allows immediate wound coverage and preserva
tion of functional amputation stump length, without the morbidity of a
n additional donor site. We present three cases that demonstrate the u
tility of this technique as an additional reconstructive option in pat
ients with unreplantable upper-extremity amputations.