Flap pre-fabrication represents an interesting technique in tissue-defect reconstruction. In this article we report the successful clinical application of a free pre-fabricated flap using an isolated arterialised venous loop as an implanted vascular pedicle for reconstruction of an extended soft-tissue defect on the leg, as well as clinical neo-vascularisation development following arterialised venous loop implantation. The procedure appears potentially useful in selected patients due to the easy harvest of an isolated vein loop as well as a favourable functional and aesthetic result at the donor site.