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CC BY-NC-ND 4.0 · Indian J Plast Surg 2024; 57(03): 208-215
DOI: 10.1055/s-0044-1787177
Original Article

Versatility of the Keystone Design Perforator Island Flaps in Resurfacing Soft Tissue Defects

Ranjit Kumar Sahu 
1   Department of Burns and Plastic Surgery, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
,
Kaushik Mahadik 
1   Department of Burns and Plastic Surgery, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
,
Sanjay Kumar Giri 
1   Department of Burns and Plastic Surgery, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
,
Santanu Suba
1   Department of Burns and Plastic Surgery, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
,
Mainak Mallik 
1   Department of Burns and Plastic Surgery, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
,
Ritesh Panda 
2   Department of Trauma & Emergency, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
,
Aparna Kanungo
1   Department of Burns and Plastic Surgery, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
,
Reena Minz
1   Department of Burns and Plastic Surgery, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
,
Sunil Kumar Rout 
3   Department of Plastic and Reconstructive Surgery, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Abstract

Background The keystone design perforator island flap (KDPIF) is unique among local flaps because of its high potential for adaptation. We describe our experience with the use of the keystone flap for the reconstruction of a variety of defects in different regions of the body concerning its versatility, surgical outcomes, complications, postoperative pain, operative time, and esthetic outcomes.

Methods A prospective observational study was conducted at our institute from June 2021 to June 2023 where the use of KDPIFs in resurfacing soft tissue defects of different etiopathogenesis was evaluated and the data were analyzed.

Results Forty-four patients were included in the study with soft tissue defects of various etiologies and at different locations. The largest flap raised was 18 × 10 cm and the smallest was 4 × 2 cm. The average intraoperative time for completion of the procedure was 74.86 minutes (range: 45–120 minutes). The success rate of flap survivability was 95.45% with two patients having total flap loss necessitating another reconstructive option. Partial flap dehiscence which healed secondarily was observed in two patients. Postoperative pain showed a significant fall of 83.7% from baseline and 82.9% of cases were extremely satisfied with the esthetic outcome.

Conclusion The keystone flap is a valuable reconstructive tool in the armamentarium of a plastic surgeon. It is technically reproducible, suitable to be done in resource-limited settings, and provides contiguous tissue with good vascularity and fewer complications.

Keywords

keystone flap - island flap - local flap'

Ethical Approval

The article has been prepared in compliance with the ethical standards of our institution and has been approved by the institutional ethics committee. Informed consent was taken from all the patients for participation in the study.




Publikationsverlauf

Artikel online veröffentlicht:
06. Juni 2024

© 2024. Association of Plastic Surgeons of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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