A Novel Modification of Keystone Flap for Superficial Defects Repair

In 2003, Behan1 was the first to report the Keystone Design Perforator Island Flap (KDPIF). The KDPIF has the advantages of simple design, convenient operation, certain perforator blood supply, adjacent tissue, good appearance and nearby texture. Therefore, it has been widely applied to repairing skin soft tissue defects caused by trauma, tumor resection, and scars.2,3 However, the KDPIF has certain issues such as excessive tension, constraint on the closure of the donor area,4,5 and skin contractures due to straight line scars across the joints in repairing large-size defects of the trunk, the joints or other moving areas.

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