Unna Boot With Keystone Advancement Flap Leads to Excellent Outcomes for Lower Extremity Reconstruction

The reconstruction of lower extremity defects can be technically challenging. The keystone island perforator flap is a workhorse reconstructive option for difficult-to-repair regions, including the lower limb. The goal of this study is to evaluate outcomes using the keystone flap in combination with the zinc oxide compression dressing (Unna boot) for repair of lower extremity defects.

We retrospectively evaluated 96 patients who underwent resection of malignancies or atypical neoplasms on the lower legs. A total of 114 defects were repaired with the keystone flap in combination with the Unna boot. Post-operative outcomes were assessed.

The combination of the keystone flap with postoperative Unna boot application led to excellent outcomes. There was no association between complication rates and patient co-morbidities.

The combination of the keystone flap with the Unna boot is a safe and efficacious approach for reconstruction of lower extremity defects. J Drugs Dermatol. 2021;20(12):1308-1312. doi:10.36849/JDD.5915.