Minimizing donor-site morbidity following limbs’ injuries with keystone perforator island flap reconstruction

Timea H. Virág MD, Maximilian V. Muntean MD, PhD, Alexandru V. Georgescu MD, PhD

 

Plastic surgeons strive to choose better techniques to reconstruct the defects of the limbs, minimizing the wound healing problems, improving the aesthetic and functional outcome with less complications. This study refers to the use of keystone perforator island flap in limbs’ reconstruction, their harvesting technique to minimize donor-site morbidity, maximize the functional and cosmetic outcome, and will point on the most important indications and advantages. Between January 2014 and June 2020, a number of 28 cases were treated in our department, with simple or complex defects of the limbs. The database included patients’ demographics, comorbidities, etiology, characteristics of the flap, surgical factors, follow-up period, flap outcomes. We performed 28 keystone perforator island flaps, 14 of Type I, 12 of Type IIA, 1 of Type III, 1 of Type IV, with an average size of 69 cm2 (ranged from 1.25 cm2 to 318 cm2). Trauma was the major cause of the defects. One flap exhibited approximately 4% partial superficial necrosis. All donor sites healed without any adverse events. All patients were satisfied with the functional and aesthetic results. The keystone perforator island flaps provide a simple and effective method of wound closure by using tissues of similar texture, thickness, color. Preserving the main artery and the underlying muscle this flap reduces the donor site morbidity. The use of keystone perforator island flaps seems to be one of the most suitable choices whenever possible … read more


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