Dear, oh, dear, this is exactly the sort of 'quactitioning' certain absent medics get so excited about. Pre-tibial lacerations are notoriously prone to complications - lets say the flap becomes necrotic, then requires grafting, or infection supravenes, progressing into the missed hairline fracture [after all, nearly all 80yr old females are osteoparotic]. What about continuity of care since pre-tibial lacs usually take weeks and sometimes months to heal ? Oh, I could go on, but you get the general drift.......... It takes a brave man to stick his head above the health & safety parapet nowadays - how long before the Obergruppenfuhrer for risk management will be knocking on your door to check your papers ? Of course, as a self-confessed quack I couldn't possibly comment about whether or not we should be taking our health services in this type of direction ;o)