Exposure of blood vessels or nerves of the medial elbow, or exposure of the bone of the lateral elbow must be covered using a skin flap. Although a number of either normal flow or reverse flow vascularized flaps can be created in the elbow region, in many cases blood vessel damage is also present, and there are often restrictions on the size of the flap, so focusing only on the upper arm can make surgery more difficult. In spite of large dissection, a vascularized latissimus dorsi flap is stable and practical.

With skin graft using negative pressure wound therapy, because the elbow is not required to be fixed in place, there is less chance of contracture occurring, and even when graft conditions are poor, there is a high ratio of the graft taking, making it extremely practical.