Background: The keystone perforator island flap (KPIF) was described almost a decade ago. However, this flap has only recently been recognized for its advantages in various clinical applications in plastic surgery. A better understanding of the versatility of KPIFs can help promote the widespread adoption of this technique for complex wounds in various anatomical regions.
Methods: A retrospective chart review was conducted of patients undergoing KPIFs from December 2018 to March 2022 at the authors' home institution. The indications, surgical approaches, patient characteristics, and outcomes were extracted for review and analysis.
Results: A total of 12 patients (ages 13-86 years) underwent reconstruction with KPIFs for oncologic and nononcologic defects. By anatomic region, three cases involved the upper back, six involved the lumbosacral region, one involved the perineum, and two involved the midfoot. Half of the patients (n = 6) had failed previous attempts at wound closure. The mean defect size was 13.8 × 10.0 cm for the upper back lesions, 13.7 × 4.8 for the lumbosacral defects, and 3.5 × 2.0 for the metatarsal wounds. Median follow-up time for all patients was 7.5 months (IQR: 4-10.5). On follow-up, there was 100% flap survival.
Conclusion: KPIFs are a simple, safe, and suitable option for reconstructive closure of defects in many anatomical areas, including wounds complicated by previous failed closure attempts, with low complication risk profile.
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http://dx.doi.org/10.1097/GOX.0000000000005556 | DOI Listing |
Indian J Plast Surg
December 2024
Department of Plastic Reconstructive Surgery, ASST Valle Camonica, Esine, Brescia, Italy.
The keystone design perforator island flap (KDPIF) was first described by Behan in 2003 as a pliable flap, suitable for all body areas thanks to its curvilinear shape, which made it apt to fit mostly all cutaneous defects. In this article, we aim to share our experience using KDPIF for the reconstruction of different defects. A retrospective analysis of patients who underwent cutaneous excision after trauma or tumor resection and reconstruction with a KDPIF at our department from 2020 to 2023 was performed.
View Article and Find Full Text PDFEar Nose Throat J
December 2024
Department of Stomatology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.
To investigate the effect of Keystone Design Perforator Island Flap (KDPIF) in the repair of maxillofacial soft tissue defect. From June 2021 to June 2023, 16 patients with soft tissue defects caused by resection of maxillofacial tumor repaired by KDPIF were selected. Variants of KDPIF were designed according to the area of the defect, and the incision was parallel to the wrinkle as far as possible in the same facial cosmetic subunit.
View Article and Find Full Text PDFIndian J Dermatol
October 2024
Department of Burns and Plastic Surgery and Hypospadias and VVFs Clinic, Postgraduate Institute of Medical Sciences (PGIMS), University of Health Sciences, Rohtak (UHSR), Haryana, India.
Purpose And Background: To create awareness among dermatosurgeons about the versatility of keystone flaps in re-surfacing post-excisional small, medium and large skin defects.
Aims And Objectives: Single-staged tension-free re-surfacing of various sized skin defects using keystone flap and to have least donor site morbidity, primary healing and maximum functional outcome.
Material And Methods: This retrospective study was conducted, between October 2021 - January 2023 in Department of Plastic Surgery, PGIMS Rohtak, on 15 males and 1 female aged between 18 - 65 years.
J Plast Reconstr Aesthet Surg
November 2024
Department of Stomatology, The Affiliated Hospital of Qingdao University, Qingdao 266000, Shandong, China. Electronic address:
Background: Many repair techniques have been recommended to treat lower lip defects. Although effective in many instances, some techniques are accompanied by complications, such as flap necrosis, dysesthesia of the lip, lip flattening, shortening, and loss of the vermillion roll. This study aimed to report the use of keystone design perforator island flap (KDPIF) in small to medium defects to achieve an effective and functional reconstruction of vermillion defects after Mohs surgery for lip cancer.
View Article and Find Full Text PDFCureus
October 2024
Department of Surgery, Sana'a University, Sana'a, YEM.
Background In Yemen, traumatic wounds are prevalent, imposing a substantial burden on plastic surgery teams operating within limited-resource settings. Advanced microsurgical reconstruction options are scarce, and expertise in free flap techniques is limited. While local flaps are commonly used for soft tissue reconstruction, there is a need for simpler, effective alternatives with lower complication rates.
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