Flaps are important in covering defects caused by trauma, tumor excision, lower limb vascular ulcer, or diabetes mellitus. Distal flap necrosis is one of the most common postoperative complications for flaps, leading to increased morbidity, prolonged hospital stay, and the need for repeat surgery. Pentoxifylline (PTXF) is a vasoactive agent that improves the flow of blood by reducing its viscosity. In our patient, we studied the usefulness of pentoxifylline as an adjuvant to prevent flap necrosis.