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Coronoid-Temporalis Pedicled Flap for Orbital Floor Defect Reconstruction
Published on: December 5, 2025
[Keystone flap for reconstruction of skin defects]
Line Bro Breiting1, Alessandro Venzo, Karin Dahlstrøm
1Brystkirurgisk klinik, Rigshospitalet, DK-2100 København Ø, Denmark. line.breiting@get2net.dk
Ugeskrift for Laeger
|December 17, 2009
Summary
The keystone flap, a versatile local flap, offers reliable reconstruction for skin defects with minimal complications. This technique provides excellent cosmetic outcomes and allows for shorter hospital stays, making it a valuable surgical option.
Area of Science:
- Plastic Surgery
- Reconstructive Surgery
Context:
- The keystone design perforator island flap, first described in 2003, is a local flap based on axial perforators.
- It is a curvilinear, trapezoidal flap, essentially two V-Y flaps, successfully utilized across the body, particularly for lower limb reconstructions.
Purpose:
- To evaluate the efficacy and safety of the keystone flap in reconstructing defects after skin malignancy excision.
Summary:
- A retrospective review of 21 patients (24 flaps) undergoing skin malignancy excision and reconstruction with keystone flaps.
- Reported complications included two cases of superficial infection and two cases of minor flap necrosis, both managed conservatively.
Impact:
- The keystone flap demonstrates high reliability with low complication rates, suitable for surgeons of all levels.
- Offers superior cosmetic results compared to skin grafting and enables shorter hospitalizations, potentially same-day or one-day surgery.
