Application Of Keystone Flap In The Repair Of Soft Tissue Defect Of Lower Extremity

Objective: To study the clinical efficacy of Keystone flap in the repair of soft tissue defect of lower extremity.Methods: A total of 27 cases with soft tissue defects of lower extremity using the Keystone flap from January 2018 to June 2020 were retrospectively analyzed.There were 18 males and 9 females,an average age of 43.8 years.The cause of soft tissue defects included skin tumor in 3 cases,ulcer in 2 cases,soft-tissue infection in 8cases,trauma in 7 case and donor site defect after free or pedicled flap transplantation in 7case.Defect size ranged from 1.5cm×2cm×0.5cm to 9.5cm×15cm×1.6cm.Postoperative complications,hospitalization time,operative time,and effectiveness of soft tissue repair were observed and recorded.Results:The types of flaps used include type I in 2 cases,type IIa in 16 cases,type IIb in 1 case,type III in 6 cases,and modified type in 2 cases.All patients were followed up 3-26 months(mean,11.5 months).All flaps survived and healed successfully except 3 cases occurred with complication include wound dehiscence in 1case and partial necrosis in 2 cases which were healed completely after d ress ing c ha nge.Conclusion:Keystone flap is an excellent alternative option in the treatment of soft-tissue defect in the lower extremity,especially applicable in county hospital which does not equipped by microsurgical technique.However,keystone flap can be applied in the reconstruction of larger defect with proper use of microsurgical skills to accurately separate and protect the perforating vessels...