Keystone flap: versatile flap for reconstruction of limb defects

Area of Science:

• Orthopedic Surgery
• Plastic Surgery
• Reconstructive Surgery

Background:

• Limb defects necessitate simple, reproducible, and time-efficient reconstruction solutions.
• The keystone flap presents a durable and easily reproducible option for addressing various limb defects.

Purpose of the Study:

• To evaluate the efficacy and utility of the keystone flap in reconstructing diverse upper and lower limb defects.

Main Methods:

• A retrospective case series analysis of 20 patients who underwent keystone flap reconstruction between 2012 and 2014.
• Evaluation of patient demographics, comorbidities, surgical indications, defect characteristics, and post-operative outcomes.

Main Results:

• The study included 20 patients (ages 18-65) with defects resulting from trauma, tumor resection, abscess debridement, and wound dehiscence.
• Keystone flaps successfully reconstructed defects ranging from 8x4 cm to 45x18 cm, with an average operative time of 45.5 minutes.
• A 95% overall success rate was achieved, with only one case of partial flap necrosis and an average hospital stay of 3.45 days.

Conclusions:

• The keystone flap is a safe and effective method for covering limb defects, offering sensate coverage and superior cosmetic outcomes.
• This technique minimizes operative time and the requirement for advanced microsurgical procedures.
• The keystone flap is a valuable reconstructive option for various limb defects.