We read with great interest the case report by Brunetti et al. (2023). which offered a series of interesting insights. They illustrated the case of a patient presenting a large soft tissue defect in the back, covered by a local perforator-based flap. Intraoperatively, the flap encountered a partial insufficient vascularization, confirmed with indocyanine green (ICG) imaging. The cause for this issue was defined as a venous congestion and it subsequently improved after a supercharge venous anastomosis, resulting in a remarkable final outcome.