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The keystone perforator flap (KPF) offers versatile reconstruction for complex defects. Its design ensures flap viability, allowing for extensive undermining and simpler surgical procedures with reduced operative times.

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Area of Science:

  • Plastic Surgery
  • Reconstructive Surgery
  • Surgical Innovation

Background:

  • The keystone perforator flap (KPF) was introduced in 2003 for skin cancer reconstruction.
  • Its application has broadened to diverse complex defects across the body.

Purpose of the Study:

  • To provide a comprehensive review of the keystone perforator flap.
  • Emphasis on classifications, applications, limitations, and surgical technique.

Main Methods:

  • Review of existing literature and documented advancements in KPF techniques.
  • Discussion of KPF physiology and surgical principles.

Main Results:

  • The KPF is a perforator flap with a 1:1 flap-to-defect ratio, utilizing perforator vessels.
  • Key advantages include enhanced flap viability due to preserved perforasomes, allowing aggressive undermining.
  • The technique is relatively simple, leading to shorter operative times and no required postoperative monitoring.

Conclusions:

  • The KPF is an adaptable and effective reconstructive tool with four main classifications.
  • Advancements have expanded its use for various conditions, including myelomeningoceles and specific defects in the scrotum and eyelids.