Abstract
Free flap procedure provides an overall success rate of 97%,which decreases to 85%in hypercoagulable states.COVID-19,as a pro-thrombotic disorder,therefore seems detrimental to free flap survival.We encountered a case of unique pattern of free flap partial failure in a young male who underwent ex-tremity reconstruction.The patient was diagnosed as COVID-19 positive on the 3rd day post-reconstruction.The flap survived well for the first 7 days post-operatively,but gradually the skin got necrosed and the subcutaneous fat layer was preserved when debriding.To our knowledge,this is the only case in which the skin of the free flap of a COVID-19 positive patient was necrosed almost entirely subsequently,while the subcutaneous fat was relatively preserved.