A New Keystone Flap “Plus” Design: Case Series and Analysis of Follow-Up

The original keystone island flap, originally described by Behan (1), is a surgical technique used after the removal of skin cancer in order to close skin defects. It is essentially two end-to-side V-Y flaps based on fasciocutaneous perforators, offering both the robust vascularity of perforator flaps and the relative ease and speed of local tissue rearrangement (2). Some authors (3, 4) highlight the advantages of this technique. Other authors applied their own modifications improving the technique (5).

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