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Related Experiment Video

Updated: Dec 7, 2025

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Keystone Flap as a Reconstructive Option for selected areas; A Prospective Study.

Sunil Srivastav1, Samarth Gupta1, Abhishek Sharma1

  • 1Department of Plastic Surgery, SMS Hospital, Jaipur, India.

Journal of Clinical Orthopaedics and Trauma
|October 1, 2020
PubMed
Summary

The Keystone flap is a versatile and simple surgical technique for covering defects, especially in the lower limb. With a 95% success rate and minimal complications, it offers a reliable reconstruction option.

Keywords:
Keystone flapLimb defectsNon microsurgical reconstructionTrauma reconstruction

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Area of Science:

  • Plastic Surgery
  • Reconstructive Surgery
  • Surgical Techniques

Background:

  • The Keystone flap is a versatile surgical option for defect coverage.
  • There is a growing need for effective lower limb defect reconstruction.
  • This flap offers a simpler alternative to microsurgery.

Purpose of the Study:

  • To evaluate the efficacy and safety of the Keystone flap for various defects.
  • To assess key outcomes including operation time, hospital stay, and complications.

Main Methods:

  • A prospective study was conducted from October 2017 to December 2019.
  • 50 patients with defects in the lower limb, upper limb, and trunk were included.
  • Flap size, operation time, hospital stay, and complications were assessed. Preoperative Doppler marking of perforators was performed.

Main Results:

  • The Keystone flap was used for 50 defects (30 lower limb, 10 upper limb, 10 trunk).
  • Average operation time was 50 minutes; average hospital stay was 3 days.
  • The overall success rate was 95%, with minor complications like partial flap necrosis and wound infection in a few cases.

Conclusions:

  • The Keystone flap is a versatile, easy-to-perform option with good vascularity and low complication rates.
  • It enables single-stage reconstruction and is suitable for both novice and experienced surgeons.
  • The Keystone flap is recommended for a wide range of defects due to its effectiveness.