Background: Pre tibial lacerations, a common surgical referral, disproportionately affect the elderly due to fragile skin and multiple comorbidities leading to complications and prolonged recovery. Methods: Scoping reviews were conducted via PubMed, MEDLINE, Cochrane, and internet searches to identify clinical studies and guidelines which commented on management and complications of pre-tibial lacerations in adults age >65. Results: Majority of literature demonstrated a preference towards conservative management of pre-tibial wounds when possible. Despite this, a variety of operative strategies were discussed including split thickness skin grafting, flap preservation, and appropriate donor site management. This data however saw a significant variation in surgical timing, setting, and technique. Post operatively, the use of negative pressure therapy showed prolonged hospital stays. Evidence also suggested early mobilisation was favoured over bed rest to shorten time to discharge. The most common complication was found to be wound infection. Overall, the literature failed to identify whether non-operative approach was superior to surgical interventions. Papers analysed all showed promising but variable evidence. Further gaps were noted in post operative care namely antibiotic use and evaluation of comorbidities on decision making. Conclusions: There does not appear to be a consensus opinion in the management of pre-tibial lacerations in the elderly underscoring the need for more robust, standardised guidelines aimed at optimising management in this high-risk population. 1: Glass GE, Jain A. Pretibial lacerations: experience from a lower limb trauma centre and systematic review. J Plast Reconstr Aesthet Surg. 2014 Dec;67(12):1694-702. doi: 10.1016/j.bjps.2014.08.001 2: Lo S, Hallam MJ, Smith S, Cubison T. The tertiary management of pretibial lacerations. J Plast Reconstr Aesthet Surg. 2012 Sep;65(9):1143-50. doi: 10.1016/j.bjps.2011.12.036