<abstract xmlns="http://www.w3.org/1999/xhtml"><p> Closure of skins and soft tissue defects is a mainstream procedure in the field of reconstructive plastic surgery. Nowadays plenty of reconstructive options exists in the armamentarium of the specialty. The “keystone island perforator flap” is a relatively new conception which consists of taking skin and superficial fascia in a keystone pattern adjacent to the defect that needs to be covered. This technique is based on the most contemporary knowledge of the vascularization and three-dimensional vascular architecture of the skin and soft tissue overlying the bones - the so called angiosomes and perforasomes concepts. In the present article a brief review of the main keystone fl ap types and on their predecessor - the Bezier flap, was made. Two clinical cases with difficult defects on the limbs are presented and discussed in order to illustrate the application of that approach. The keystone perforator island flaps is a sophisticated and relatively easy option for defect closure. However, this surgical concept still remains unpopular in the Bulgarian practice and science of plastic surgery. To the best of our knowledge this paper is the first one focused on the topic.</p></abstract>

Closure of skins and soft tissue defects is a mainstream procedure in the field of reconstructive plastic surgery. Nowadays plenty of reconstructive options exists in the armamentarium of the specialty. The “keystone island perforator flap” is a relatively new conception which consists of taking skin and superficial fascia in a keystone pattern adjacent to the defect that needs to be covered. This technique is based on the most contemporary knowledge of the vascularization and three-dimensional vascular architecture of the skin and soft tissue overlying the bones - the so called angiosomes and perforasomes concepts. In the present article a brief review of the main keystone fl ap types and on their predecessor - the Bezier flap, was made. Two clinical cases with difficult defects on the limbs are presented and discussed in order to illustrate the application of that approach. The keystone perforator island flaps is a sophisticated and relatively easy option for defect closure. However, this surgical concept still remains unpopular in the Bulgarian practice and science of plastic surgery. To the best of our knowledge this paper is the first one focused on the topic.

The Keystone Perforator Flap Concept – A Useful Tool in the Armamentarium of Plastic Surgery

FEBOPARS, Department of Plastic Reconstructive and Aesthetic Surgery, MHAT “Uni Hospital”, Bg - 4500 Panagyurishte,

Department of Diagnostic Imaging, University Hospital “Alexandrovska” – Sofia,

Department of Dermatovenereology and Allergology, Military Medical Academy – Sofia,

4Department of Orthopedic, Traumatology And Reconstructive Surgery, Military Medical Academy – Sofia,

Acta Medica Bulgarica

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Closure of skins and soft tissue defects is a mainstream procedure in the field of reconstructive plastic surgery. Nowadays plenty of reconstructive options...

The Keystone Perforator Flap Concept – A Useful Tool in the Armamentarium of Plastic Surgery

Published Online: Nov 23, 2016

Page range: 32 - 38

DOI: https://doi.org/10.1515/amb-2016-0014

Keywords
keystone perforator island flap, Bezier flap, perforasomes, local plasty

© 2016

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

The Keystone Perforator Flap Concept – A Useful Tool in the Armamentarium of Plastic Surgery

Published Online: Nov 23, 2016

Page range: 32 - 38

DOI: https://doi.org/10.1515/amb-2016-0014

Keywordskeystone perforator island flap, Bezier flap, perforasomes, local plasty

© 2016

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Keywords
keystone perforator island flap, Bezier flap, perforasomes, local plasty