Utilization of Novel Keystone Flap Modification on Various Anatomic Sites

Abstract

ABSTRACT We describe our proposed modification of the keystone flap, which adds a V-Y advancement in 3 directions, further optimizing the redistribution of tension forces. This new approach not only improves the overall stability of the flap but also reduces the risk of wound dehiscence and enhances the potential for better healing outcomes. We describe its use in 15 patients treated at our center (mean age of 58 years [range, 18-77 y]) with mean follow-up time of 14 months (range, 6-24 mo). All flaps survived, and no early or late complications were encountered. The keystone flap’s flexibility, combined with its multiple modifications, continues to expand its applicability across diverse anatomical locations, making it a vital tool in reconstructive surgery for complex defects.