To the Editor,We would like to thank the authors of the letter to the editor [1] for sharing their experience with us. We share their enthusiasm for this pedicled flap for many of the same reasons.Although not fully assessed in our retrospective study [2], several patients underwent surgery entirely under a regional anesthetic while in the prone position. Moreover, we harvest a skin graft to cover the donor site from the neighboring skin of the leg, which also is anesthetized and easily covered with a splint postoperatively. Before the coronavirus disease 2019 (COVID-19) pandemic, the goal was merely to avoid the risks of a general anesthetic in older patients. During the COVID-19 crisis, we agree that avoiding the oropharynx from the laryngeal mask airway or endotracheal intubation is preferred.Although not addressed in our study [2], we also try to perform these procedures on an outpatient basis when possible. This allows us to use fewer resources at our surgery center and send the patient home between stages. During the current crisis, this would conform to social distancing recommendations, limit patient and staff exposure to nosocomial infections including COVID-19, and limit the use of inpatient hospital resources.We are encouraged to hear of the letter writers’ experiences with this flap. The goal of our paper was to stimulate interest in this versatile flap by showing our success in older patients.