Loco regional muscles in lower extremity trauma may be involved within the zone of injury. While these flaps may be rotated to cover a defect, the complication rate is higher owing to injured tissue. In this study, the vacuum assisted closure (VAC) device was used in the perioperative period to treat the regionally transferred muscle. Methods: This is a retrospective review of 12 patients who all had lower extremity trauma. The defects were in the proximal third (5) and middle third (7) of the leg. There were 10 male and 2 female patients. All patients had either a gastrocnemius or soleus muscle flap performed. The skin graft was delayed in all patients. The regional defect was covered by a single muscle in each of these cases. Results: There were no complete flap failures and two patients had distal tip necrosis of the flap but did not require any other form of treatment. The remaining patients had complete survival of the flap. The patients were either returned to the operating room for skin grafting or had already harvested skin grafts placed at the bed side. Conclusion: Loco regional muscles may be involved in extremity trauma. The soleus and gastrocnemius muscle are in the superficial posterior compartments. In lower extremity injuries the zone of injury may extend beyond the deep posterior compartment and include the more superficial compartments. The vacuum assisted closure device had unique properties that help augment tissue blood flow. The VAC can be used safely and successfully to augment blood flow in marginally ischemic tissue. In this study 12 such patients had the VAC placed to help with the flap survival. The technique for application, treatment algorithm and discussion of the mechanisms of action will all be presented.