مجله جهانی جراحی پلاستیک
مجله جهانی جراحی پلاستیک
شنبه 14 شهریور 1405
[Archive]
چکیده: (4 مشاهده)
Background: We aimed to evaluate the versatility, safety and wide clinical applications of the keystone flap in reconstruction following skin cancer excision and in soft tissue defects of varying sizes across the head, neck, limbs and trunk, with respect to aesthetic and functional outcomes.
Methods: A scoping review of published literature was undertaken in accordance with PRISMA-ScR guidelines. PubMed, ScienceDirect and Google Scholar were searched. The initial focus was on keystone flap reconstruction following melanoma excision. However, due to limited melanoma-specific data, the inclusion criteria were expanded to include studies involving all skin cancers, including squamous cell carcinoma and basal cell carcinoma, as well as broader reconstructive applications of the keystone flap in soft tissue defects to enable a more comprehensive evaluation of outcomes.
Results: Seventeen studies published between 2003 and 2024 were included. Keystone flaps were most utilised in lower limb reconstruction following oncological excision and soft tissue defect reconstruction across multiple anatomical sites. Complication rates ranged from 0% to 38.8%, with the majority classified as minor and managed conservatively. Reported outcomes demonstrated high success rates and favourable cosmetic and functional results. No standardised patient-reported outcome measures were employed across the included studies.
Conclusion: The keystone flap appears to be a versatile and reliable reconstructive option with broad applications across defects of varying sizes and anatomical sites. The available evidence suggests it may serve as an effective alternative to conventional flaps and grafts in skin cancer and soft tissue reconstruction. However, findings are derived predominantly from retrospective case series and thus should be interpreted accordingly, with prospective comparative studies warranted to further validate these outcomes.
Methods: A scoping review of published literature was undertaken in accordance with PRISMA-ScR guidelines. PubMed, ScienceDirect and Google Scholar were searched. The initial focus was on keystone flap reconstruction following melanoma excision. However, due to limited melanoma-specific data, the inclusion criteria were expanded to include studies involving all skin cancers, including squamous cell carcinoma and basal cell carcinoma, as well as broader reconstructive applications of the keystone flap in soft tissue defects to enable a more comprehensive evaluation of outcomes.
Results: Seventeen studies published between 2003 and 2024 were included. Keystone flaps were most utilised in lower limb reconstruction following oncological excision and soft tissue defect reconstruction across multiple anatomical sites. Complication rates ranged from 0% to 38.8%, with the majority classified as minor and managed conservatively. Reported outcomes demonstrated high success rates and favourable cosmetic and functional results. No standardised patient-reported outcome measures were employed across the included studies.
Conclusion: The keystone flap appears to be a versatile and reliable reconstructive option with broad applications across defects of varying sizes and anatomical sites. The available evidence suggests it may serve as an effective alternative to conventional flaps and grafts in skin cancer and soft tissue reconstruction. However, findings are derived predominantly from retrospective case series and thus should be interpreted accordingly, with prospective comparative studies warranted to further validate these outcomes.
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