WORLD JOURNAL OF PLASTIC SURGERY

en Critical Evaluation of Keystone Reconstruction: A Retrospective Series of 32 Cases تخصصي Special مقالات اصيل Original Article Background: We aimed to create focus and awareness about versality of keystone flap in safe re-surfacing of small to medium and large sized skin defects in single stage with minimal donor site morbidities and maximum anatomical, functional and aesthetic results. Methods: Retrospective study was conducted between October 2021– December 2022 on 26 males and 5 females aged 20-70 years who underwent 32 Keystone flap reconstruction (type IIA n=11, type IIB n=7 type III n=6, Type IV n=8) in diversity of defects following: domestic electric burn on pulp of thumb (n=2), chronic discharging sinus over clavicle (n=1), post-traumatic wounds on eighteen legs (n=19), excision of unstable scar over shin of tibia (n=4), exit wound on medial aspect of foot (n=3) and excision of non-healing ulcer over heel (n=3). Flaps were designed in a way to keep maximum perforators in pedicular area and to ascertain maximum mobility. After debridement, wound area ranged from 4mm x 4mm to 17 x 8 cm. The flap size ranged from 5mm x 5mm to 18cm x 8cm. Follow- ups ranged from 1 month to 12 months. Results: Three cases developed partial wound dehiscence which were managed subsequently. None of the flap had partial or total loss. Over-all results were satisfying. Conclusion: Our series highlighted that keystone flaps have defect adaptive design and are technically easy to perform, cost and time effective and can be designed from head to toe (omnipresence) with excellent outcome. We advocate their use as robust reconstructive tool for Plastic surgeons, Orthopedic surgeons and Dermatosurgeon.   Keystone flap, Omnipresence, Perforator 103 121 http://wjps.ir/browse.php?a_code=A-10-884-5&slc_lang=en&sid=1 Abhinav Singh abhi2889@gmail.com 100319475328460017062 100319475328460017062 Yes Department of Burns and Plastic Surgery, AIIMS, Saket Nagar, Bhopal - 462020 (MP) India Abhishek Sharma 100319475328460017063 100319475328460017063 No Department of Burns and Plastic Surgery, Postgraduate Institute of Medical Sciences (PGIMS), University of Health Sciences, Rohtak (UHSR). Haryana. India Rohini Singh 100319475328460017064 100319475328460017064 No Department of Dermatology, AP, LNCT Medical College and Research Center, Bhopal- 462042, Madhya Pradesh. India Kuldeep Singh 100319475328460017065 100319475328460017065 No Department of Burns and Plastic Surgery, Postgraduate Institute of Medical Sciences (PGIMS), University of Health Sciences, Rohtak (UHSR). Haryana. India RB Singh 100319475328460017066 100319475328460017066 No Department of Burns and Plastic Surgery & Hypospadias and VVFs Clinic, Postgraduate institute of Medical Sciences (PGIMS), University of Health Sciences, Rohtak (UHSR) Aksha Mohan 100319475328460017067 100319475328460017067 No Department of Orthopedics, Postgraduate Institute of medical Sciences (PGIMS), University of Health Sciences, Rohtak (UHSR), Haryana, India