Pretibial lacerations are often followed by slow healing. When a flap is raised, simple suture is doomed to failure and both a conservative approach and one involving skin grafting have been advocated. In this study, 25 patients with pretibial flap lacerations were randomly allocated to treatment either by primary excision and grafting or by "defatting" the flap and laying it on the defect. Healing times were compared in the two groups. Our results showed that healing time was significantly faster in the grafted group (mean 13.2 days) than in the defatted group (mean 40.7 days), Student's t test = 3.29 (p less than 0.01).