Minimising donor‐site morbidity following limbs' injuries with keystone perforator island flap reconstruction

Plastic surgeons strive to choose better techniques to reconstruct the defects of the limbs, minimising the wound healing problems, improving the aesthetic and functional outcome with less complications. This study refers to the use of keystone perforator island flap (KPIF) in limbs' reconstruc...

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Bibliographic Details
Published in:Wound repair and regeneration 2022-05, Vol.30 (3), p.357-364
Main Authors: Virág, Timea H., Muntean, Maximilian V., Georgescu, Alexandru V.
Format: Article
Language:English
Subjects:
Humans
keystone perforator island flap
limbs
Morbidity
Perforator Flap - surgery
reconstruction
Reconstructive Surgical Procedures - adverse effects
Reconstructive Surgical Procedures - methods
Skin Transplantation
Soft Tissue Injuries - surgery
Treatment Outcome
wound
Wound Healing
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Summary:Plastic surgeons strive to choose better techniques to reconstruct the defects of the limbs, minimising the wound healing problems, improving the aesthetic and functional outcome with less complications. This study refers to the use of keystone perforator island flap (KPIF) in limbs' reconstruction, their harvesting technique to minimise donor‐site morbidity, maximise the functional and cosmetic outcome, and will point on the most important indications and advantages. Between January 2014 and June 2020, a number of 28 cases were treated in our department, with simple or complex defects of the limbs. The database included patients' demographics, comorbidities, aetiology, characteristics of the flap, surgical factors, follow‐up period and flap outcomes. We performed 28 KPIFs, 14 of type I, 12 of type IIA, 1 of type III, and 1 of type IV, with an average size of 69 cm2 (ranged from 1.25 cm2 to 318 cm2). Trauma was the major cause of the defects. One flap exhibited approximately 4% partial superficial necrosis. All donor sites healed without any adverse events. All patients were satisfied with the functional and aesthetic results. The KPIFs provide a simple and effective method of wound closure by using tissues of similar texture, thickness and colour. Preserving the main artery and the underlying muscle, this flap reduces the donor site morbidity. The use of KPIFs seems to be one of the most suitable choices whenever possible.
ISSN:1067-1927
1524-475X
DOI:10.1111/wrr.13007