The use of modified keystone flap in periarticular or large superficial tumor resection surgery

Fang, Shuo; Li, Yingli; Tang, Weiya; Zhu, Weiye; Zhuang, Wei; Xing, Xin; Yang, Chao

doi:10.1002/jso.25879

Cited by 5 publications

(9 citation statements)

References 18 publications

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“…Twenty-three articles met the inclusion criteria for quantitative analysis and are described in Table 1 . 2 4 13 14 15 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 One of these articles (Behan 2003) 14 was excluded from quantitative analysis due to lack of outcomes reporting. Two investigators then independently reviewed all articles and extracted the data using a standardized form.…”

Section: Resultsmentioning

confidence: 99%

“…26 Fang designed a "boatshaped" modification in which an additional triangle of tissue is added to the side of the flap contralateral to the defect, thus adding a third V-Y component to the reconstruction (31 patients). 34 Bhat described three additional modifications. Type B and C only use partial components of the keystone flap incisions that do not communicate with the defect itself.…”

Section: Resultsmentioning

confidence: 99%

“…The keystone flap is designed based on the angiotome principle. Mohan, Darrach, and Fang routinely used doppler signals to identify perforators 15 30 34 although Lanni, Bhat, Yoon report that this was unnecessary in all or most of their patients. 2 21 32 33 For surgeons who are less familiar with the keystone flap, this strategy may be beneficial for flap design.…”

Section: Head and Neck Defectsmentioning

confidence: 99%

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Outcomes of the Keystone Island Perforator Flap: A Systematic Review

Weinberg

Heiman

DeSanti

et al. 2022

J Reconstr Microsurg

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Background The Keystone Design Perforator Island Flap (KDPIF), first described by Behan in 2003, has been demonstrated as a versatile, safe, and straightforward reconstructive option for various soft tissue defects. The purpose of this systematic review is to evaluate the indications, variations, and overall complication profile of the keystone flap in reconstructive surgery. Methods A literature review was conducted in accordance with PRISMA guidelines using MeSH term “surgical flaps” with the keyword “keystone flap.” Empirical studies with at least 15 patients who underwent keystone flap reconstruction were assessed for quantitative analysis. Outcomes of interest included patient demographics, indications, anatomic location, flap design, and complications. Results Database search produced 135 articles, of which 25 were selected for full-text review. Out of 23 studies selected qualitative analysis and 22 met criteria for quantitative analysis. Overall success rate of this flap was 98%. Wound complications were highest in extremity flaps. Several modifications of this flap were described. Conclusion Keystone reconstruction demonstrates excellent success rates and versatility. However, further studies with more standard reporting are needed to determine guidelines for patient specific surgical planning.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Head and Neck Defectsmentioning

confidence: 99%

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Outcomes of the Keystone Island Perforator Flap: A Systematic Review

Weinberg

Heiman

DeSanti

et al. 2022

J Reconstr Microsurg

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“…In addition to this, we thought a tail design at the posterior margin and a V-Y advance movement would be beneficial to reducing the tension. 20 The scalp keystone island flap has its own limitations, mainly because of the limited mobility of the scalp. Therefore, the flap is mainly suitable for the repair of small and medium defects.…”

Section: Discussionmentioning

confidence: 99%

Reconstruction of the Defect at Temporal Hairline by a Scalp Keystone Island Flap: Clinical Experience on 14 Cases

Tang

Lou

et al. 2022

Journal of Craniofacial Surgery

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Background: The reconstructions of defects at the temporal hairline always require more complicated designs and higher surgical skills to acquire better aesthetic results. By taking advantage of the unique anatomy of the temporal region, the authors designed a scalp keystone island flap pedicled by superficial temporal fascia to repair defects on the temporal hairline. Methods: The authors retrospectively analyzed the clinical data of 14 patients who had lesions adjacent to the temporal hairline between April 2018 and June 2020. Patients were diagnosed with basal cell carcinoma, squamous-cell carcinoma, or seborrheic keratosis. These lesions were resected and reconstructed by scalp keystone island flaps. The defects ranged from 2.0 cm × 1.5 cm to 3.0 cm × 3.5 cm. Results: All patients were satisfied with postoperative morphology and reported no recurrence at the 6 to 24 months follow-up. Flaps in two patients were partially necrosed but eventually healed by dressing changes. The rest had the first intention of healing. Conclusions: The scalp keystone island flap is a very useful method to repair small or medium defects at the temporal hairline. This flap can be flexibly designed and easily performed with a high survival rate and good aesthetic results. It provides another surgical option for complicated reconstruction.

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“…We read with great interest the article by Fang et al 1 on the modification to the keystone design perforator island flap (KDPIF), which was originally described by Behan in 2003. 2 The authors report a modification, namely a "boat-shaped" flap, whereby a V shape is added along the lateral arc of the flap, forming a V-Y flap on the KDPIF's outer arc, shaped like the sail of a boat.…”

mentioning

confidence: 99%