The Use of Keystone Flap for the Reconstruction of Skin Defects

Abstract

Background and objectives: Skin graft and various flaps are used to cover defects; available options have different patterns of blood supply, aesthetic outcome, donor area morbidity, surrounding soft tissue availability, operative time duration, the need for microsurgical expertise and long term complications. The aim of this study is to assess reliability and versatility of keystone flap for the reconstruction of the skin defects. Methods: Reconstruction of skin defects by keystone flap were done in plastic surgery department between (January 2018- May 2020), records of patient’s age, and cause of the defect, size, flap outcome and complications are documented.to study the ability of the flap to cover the skin defect and its long term survival. Results: Nineteen patients underwent reconstruction, age was ranging from two days to seventy-five-year-old with mean age 37.5 years, twelve were males and seven were females. Size of the defect ranged from (0.5 cm x 1 cm) to (9 cm x 7 cm) with mean defect size 31.75 cm2. Seven flaps in head and neck, five in the trunk, five in lower limb and two flaps in upper limb. All flaps were successful in covering the defects, no partial or total necrosis with minor complication in two patients. Conclusions: Keystone flap is a reliable flap with excellent survival rate, versatile and can be used for skin defects in different regions of the body with low complication rate, easy technique for learning by surgeons and have short operative duration with good cosmetic outcome.