Soft tissue defects in the extremities are common challenges in orthopedic surgery, often resulting from trauma, infection, or following tumor removal. When planning the closure of wounds for any reason, the reconstructive ladder must always be considered. This progresses from secondary healing to primary closure options, and on to more complex local and free tissue flaps through graft utilization. When defects in the skin cannot be closed using simple methods such as secondary healing or primary closure, alternative methods should be employed. Local or free tissue transfers, which bring their own blood supply, are frequently used for the closure of complex wounds, including those with exposed implants, tendons, and bones at joint levels, load-bearing areas, for infection control, and in preparation for planned secondary surgeries. The advantages of local flaps include appropriate color match, thickness, and potential sensitivity due to their derivation from nearby tissues. Local skin flaps can be classified according to their transfer methods (e.g., advancement, rotation, and transposition) or geometric design (e.g., rhomboid, bilobed, etc.). Complex defects may require various approaches such as multiple local flaps, a combination of local flap with skin graft, pedicled flap, or closure combining secondary healing.