Extended experience and modifications in the design and concepts of the keystone design island flap

Received 27 April 2008; accepted 18 June 2009. published online 12 November 2009.

Summary

This paper describes modifications to the design of the keystone design island flap for the reconstruction of oncological defects. In particular, the paper outlines a spectrum of modifications to the design that permit the design to be tailored to a broad range of reconstructive needs, factoring in the anatomical location of the soft tissue defect and the quality of the integument in that locality. The biomechanics of the flap are also discussed in detail.

Keywords: Melanoma, Lower limb, Leg, Reconstruction, Fasciocutaneous flap, Keystone

a Melanoma Institute Australia (incorporating the Sydney Melanoma Unit), North Sydney, NSW, Australia

b Royal Prince Alfred Hospital, Camperdown, NSW, Australia

c The Mater Hospital, North Sydney, NSW, Australia

d Discipline of Surgery, The University of Sydney, Sydney, NSW, Australia

Corresponding author. Tel.: +61 2 99117200; fax: +61 2 99549927.

PII: S1748-6815(09)00486-0

doi:10.1016/j.bjps.2009.06.028

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