With patch, you circle an area you want to process. Then you drag the circle to the spot you want to take the pixels from. It will try to blend the new pixels into the existing image. If you completely encircle a problem area, it will be replaced. If there is a substantial contrast difference at the edge of the patch, it will not produce a good result.
Try to make the source area that you obtain pixels from as close as possible to the desired result. If the patch runs through an area of high contrast, maintain the high contrast when selecting the source area.
Patch is VERY GOOD at blending areas where, clone for example, has left visible edges. I use patch at least as much as I use the clone tool, and far more than things like the healing brush.
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