Lower limb cutaneous skin cancers in Queensland are predominantly treated with primary surgical excision with reconstruction +/- post-operative radiotherapy if any high risk tumour factors i.e. depth of invasion, PNI. We present a case series of elderly patients who have been referred to a tertiary centre, plastic and reconstructive surgery team, with soft tissue defects post primary radiation treatment for lower limb cutaneous skin cancers rather than surgical excision. These patients present with mainly distal third lower limb defects with chronic wounds comprising of multiple exposed tendons and reduced range of movement in both foot and ankle. As the reconstructive surgeon it can be challenging to plan soft tissue coverage for these elderly patients who have multiple co-morbidities and are not fit for lengthy operations such as a free flap reconstruction. The delayed presentation of radionecrosis soft tissue injury in these elderly patients plus minimal improvement with hyperbaric oxygen therapy, leads to these hostile wounds requiring multiple debridements before considering reconstruction. In this particular case series different reconstructive methods were adopted in each case with varying patient outcomes with the main aim being to preserve the patients mobility/function.