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Giant keystone type III perforator flaps for dermatofibrosarcoma protuberans defect reconstruction.
Maria Eliza Nedu1, Ileana Rodica Matei1, Alexandru Valentin Georgescu1
1Department of Plastic Surgery, University of Medicine and Pharmacy "IuliuHatieganu", Cluj-Napoca, Romania; Department of Plastic Surgery Spitalul Clinic de Recuperare, Rehabilitation Clinical Hospital Cluj-Napoca, Str. Viilor 46-50, Cluj Napoca 400347, Romania.
A modified Keystone type III flap offers a viable solution for large trunk defects in dermatofibrosarcoma protuberans (DFSP) cases. This technique provides a reliable alternative to skin grafting for extensive tumor excisions.
Area of Science:
- Surgical oncology
- Reconstructive surgery
Background:
- Dermatofibrosarcoma protuberans (DFSP) is a rare, locally aggressive skin malignancy.
- Large DFSP tumors can result in significant defects requiring complex reconstruction.
Observation:
- A case of a 59-year-old male with a giant DFSP (24x36 cm) on the posterior trunk presented with anemia due to bleeding and pus.
- Surgical excision created a large defect (34x42 cm) down to the fascial level.
Findings:
- The defect was successfully reconstructed using two modified Type III Keystone flaps.
- The flaps demonstrated complete viability and integration, with minor dehiscence managed by secondary healing.
Implications:
- The modified Type III Keystone flap is presented as a reliable alternative to skin grafting for extensive posterior trunk defects.
- This represents a novel application of the modified Type III Keystone flap for a large defect in an adult patient.
