The lower leg is a common site for skin cancer in older patients. For all but the
smallest defects, split thickness skin grafts (SSG) remain the mainstay of reconstruction
in this patient group but are complicated by poor graft take, donor site morbidity
and poor aesthetics.
1
Local flaps are an attractive option, given their like-for-like characteristics but
limited soft tissue availability makes traditional local flaps challenging.To read this article in full you will need to make a payment
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References
- A comprehensive approach to lower extremity free-tissue transfer.Plast Reconstr Surg Glob Open. 2017; 5: e1228
- The keystone design perforator island flap in reconstructive surgery.ANZ J Surg. 2003; 73: 112-120
- A systematic review of the keystone design perforator island flap in lower extremity defects.Medicine (Baltimore). 2017; 96: e6842
- The keystone flap: not an advance, just a stretch.Ann Surg Oncol. 2013; 20: 973-980
- Keystone island flap: effects of islanding on vascularity.Plast Reconstr Surg Glob Open. 2016; 4: e617
Article info
Publication history
Published online: December 14, 2018
Accepted:
December 9,
2018
Received in revised form:
December 1,
2018
Received:
October 7,
2018
Identification
Copyright
© 2018 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Keystone island flaps for reconstruction following lower leg skin cancer resection: A comparison with split-thickness skin graftsJournal of Plastic, Reconstructive & Aesthetic SurgeryVol. 72Issue 11
- PreviewWe were very interested to read the correspondence by Sorooshian et al. in the March 2019 edition of JPRAS, comparing the use of keystone flaps and skin grafts for lower limb skin cancer reconstruction.1 The keystone perforator flap is widely reported as a robust and versatile local fasciocutaneous flap, with applications in the reconstruction of defects in the head and neck, within burns and over joints.5 Despite consensus that local flaps provide superior cosmetic and functional outcomes compared to split thickness skin grafts, we concur that there exists a relative sparsity of literature comparing objective and subjective outcomes in the reconstruction of skin cancer defects.
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