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Modified keystone flap for extremity defects after Mohs surgery
Julio Magliano1, Sofia Falco2, Caroline Agorio2
1Dermatologic Surgery Unit, Department of Dermatology, Hospital de Clínicas, Montevideo, Uruguay. juliomagliano@gmail.com.
International Journal of Dermatology
|July 16, 2016
Summary
The modified keystone flap effectively reconstructs large limb defects after Mohs micrographic surgery (MMS). This technique showed no complications in six patients, offering a viable solution for challenging reconstructions.
Area of Science:
- Surgical Oncology
- Dermatologic Surgery
- Plastic and Reconstructive Surgery
Background:
- Surgery is the preferred treatment for cutaneous carcinomas, enabling margin control and histopathological analysis.
- Mohs micrographic surgery (MMS) offers superior margin control and tissue preservation, but can result in large limb defects.
- The keystone flap, a fasciocutaneous island advancement flap, presents a reconstructive option for these defects.
Purpose of the Study:
- To evaluate the efficacy of the modified keystone flap in reconstructing large limb defects following MMS.
Main Methods:
- A descriptive study was conducted on six patients who underwent reconstruction using the modified keystone flap for extremity defects post-MMS.
- Data were collected between 2013 and 2014.
Main Results:
- Six patients with defects from squamous cell and basal cell carcinomas were treated.
- Reconstructions included three leg, two thigh, and one forearm defect, averaging 3.1 cm.
- The modified keystone flap procedure was well-tolerated with no observed complications like bleeding, infection, necrosis, or suture dehiscence.
Conclusions:
- The modified keystone flap proved beneficial in reconstructing limb defects in the studied patients.
- Further comparative studies are needed to fully assess its advantages over other reconstructive methods.
