I'll bet the original quilter was removing stitches she didn't like, or dropped her scissors on the quilt while working on it, and created a small hole in the fabric. She went to her neighbors who also were quilters, and showed them the small hole. She was very upset about it. One of the neighbors told her to applique a small patch over the hole, and it will look like she intended it as part of the design. And so, her hard work was saved.