Favoured Keystone Flap Applications

Abstract

The diagrams illustrating the designs of the various keystone flaps produce an irresistible challenge to trainee plastic surgeons. We believe that clinical experience is the key, with a good knowledge of basic flap principles and surgical skills required, before embarking on the keystone flap. I have selected ten keystone flaps covering the whole body, from scalp to foot, including my first and my most recent cases. Although tentative at the beginning, I soon gained confidence, and the keystone perforator island flap is now my preferred option. Photographs of all stages of this flap have served as a data record, from which I have been able to refine the procedure and avoid problems.