Introducing the subdermal free flap: Preserving the ultrathin-free skin flap option in morbidly obese patients.

In the morbidly obese population (BMI > 35), distal extremity defects are difficult to reconstruct. Traditional skin flaps are several centimeters in thickness in obese patients; however, a new plane superficial to the scarpal plane has demonstrated success in these patients. In this report, we present a 62-year-old female (BMI = 44.81) with a chronic lower extremity wound. A suprascarpal thin flap (approximately 1 cm in thickness) was harvested from the thigh and transferred successfully with no wound-healing issues.