Assessment of Reconstruction of Lower Limbs Defects Using Keystone Perforator Flaps

Subh, Alshaimaa H.; Gomaa, Amr A.; Aboelnaga, Ahmed M.; AlBadawy, Mohamed A.

doi:10.21608/scumj.2023.322602

Assessment of Reconstruction of Lower Limbs Defects Using Keystone Perforator Flaps

Document Type : Original Article

Authors

¹ Department of Plastic Surgery, Faculty Medicine, Tripoli University, Tripoli, LIBYA

² Department of Plastic Surgery, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.

10.21608/scumj.2023.322602

Abstract

Background: In reconstructive surgery, the perforator flap procedure involves removing skin and/or subcutaneous fat from a distant or nearby portion of the body in order to restore the excised part. Isolated perforators from a deep vascular system are what provide the flap its blood supply. The trapezoidal-shaped keystone perforator island flap is effectively two linked V-Y island flaps. Objectives: we aimed in this study to determine the feasibility and safety of keystone island flap in managing various limb defects. Patients and Methods: Patients who were presented to the plastic surgery department at the Suez Canal University Hospital with leg deformities were the subject of a planned cross-sectional study. 15 patients were included in the study; 10 (66.67%) men and 5 (33.33%) women had soft tissue leg abnormalities. Patients underwent a history-taking process that included gathering information about their demographics, medical histories, comorbidities, and surgical indications. Defect characteristics and placements were also evaluated, as were hospitalization and sequelae. Results: The lengths of the faults ranged from 1 cm to 5 cm, with a p-value < 0.001. There were substantial relationships between the actual means of the score's component components and the samples of their respective variables, according to the descriptive statistics of the POSAS Observer scale and its constituents' mean scores (p-value <0.001). Regarding the population of the study, there was a statistically significant variation in the distribution of problems. The remaining two patients (Fisher's exact test's p-value = 0.001) showed one or more difficulties, while the remaining 13 patients did not exhibit any complications. Conclusion: The keystone flap offers a sensitive cover, reduces the need for microsurgical procedures, and shortens the length of the operation. It is a simple and safe solution for covering a variety of limb deformities with the least amount of morbidity.

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