Keystone island flaps for reconstruction following lower leg skin cancer resection: a comparison with split-thickness skin grafts

The lower leg is a common site for skin cancer in older patients. For all but the smallest defects, split thickness skin grafts (SSG) remain the mainstay of reconstruction in this patient group but are complicated by poor graft take, donor site morbidity and poor aesthetics.1 Local flaps are an attractive option, given their like-for-like characteristics but limited soft tissue availability makes traditional local flaps challenging.

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