DOI: 10.36347/sjams.2019.v07i03.098

Pages: 1349-1354

Reconstruction of tissue defects with a similar (in terms of colour, texture, hair), simple, reliable and stable tissues remains a challenge in reconstructive surgery. Unless local surrounding tissue is used to cover the defect by a technique or method, this challenge is not fulfilled. Keystone flap are based on the three-dimensional vascular architecture of the skin and soft tissue overlying the bones so called angiosomes and perforasomes. This surgical technique applied in 36 cases is simple, versatile and with good aesthetic outcome. The aim of this study is to delineate the versatility of keystone design flaps in the reconstruction of various soft tissue defects. This is a retrospective study done for 3 years (January 2016 to January 2019) for 36 patients who underwent Keystone flaps for various defects. The age of the patients ranged from 6 to 82years.Of the 36 defects, 14 were done to reconstruct post traumatic raw areas and post infective raw areas, 12 were following excision of skin tumors, 4 done for post burn defects, 3 done for closure of donor defects, 2 done for scar revision and 1 for melanocytic naevi excision. Most of the flaps were applied in head and neck region. Only one Keystone flap done for post traumatic defect had partial flap necrosis. The keystone design flap is a versatile reconstructive option for various defects which is simple, easily reproducible, performed within a short duration, with high success rate, using surrounding local tissue to move over the defect and restore normalcy and has minimum complications.