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The keystone design perforator island flap. Part II: clinical applications
Philippe Pelissier1, Hélène Gardet, Vincent Pinsolle
1Service de Chirurgie Plastique, Hôpital Pellegrin-Tondu, 33076 Bordeaux, France. philippe.pelissier@chu-bordeaux.fr
Summary
The keystone flap, a versatile surgical technique, offers reliable reconstruction for skin defects without necrosis. This method ensures satisfactory aesthetic outcomes and is ideal for post-cancer removal repairs.
Area of Science:
- Plastic Surgery
- Reconstructive Surgery
- Dermatologic Surgery
Background:
- Describes the keystone flap as a composite of two V-Y flaps.
- Highlights its vascular supply via subcutaneous networks and perforators.
- Reviews 15 clinical cases for reliability and versatility.
Purpose of the Study:
- To assess the reliability and versatility of the keystone flap.
- To evaluate its efficacy in reconstructing various defects.
Main Methods:
- Performed 12 keystone flap procedures.
- Utilized for skin tumors and post-traumatic defects in head, neck, trunk, and limbs.
Main Results:
- Achieved zero flap necrosis (partial or complete).
- Reported minimal postoperative pain.
- Observed satisfactory aesthetic results without "pincushioning".
Conclusions:
- The flap distributes tension evenly, avoiding undermining.
- Particularly effective for defects after skin cancer excision.
- Universally applicable and reliable due to perforator and network support.
