Vessel Loop Shoelace Technique followed by Keystone Flap to Treat a Large Mid-back Defect

Summary:. The keystone design perforator island flap has been gaining popularity for reconstructing large cutaneous defects with sufficient soft tissue laxity. However, for a defect with insufficient local tissue and tense laxity such as upper to mid-back, a single keystone flap may not be so suitab...

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Bibliographic Details
Main Authors: Chia-Chun Lee, MD, Tien-Hsiang Wang, MD, PhD, Ching-En Chen, MD
Format: Article
Language:English
Published: Wolters Kluwer 2022-01-01
Series:Plastic and Reconstructive Surgery, Global Open
Online Access:http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000004049
Description
Summary:Summary:. The keystone design perforator island flap has been gaining popularity for reconstructing large cutaneous defects with sufficient soft tissue laxity. However, for a defect with insufficient local tissue and tense laxity such as upper to mid-back, a single keystone flap may not be so suitable for advancement and mobilization. Instead of an additional flap or double-opposite-designed keystone flaps, we attempted to apply the vessel loop shoelace technique for external expansion before proceeding with only one keystone flap reconstruction for a 15 × 15 cm skin and soft tissue defect on the mid-back. The outcome was a viable flap, with no ischemic flap edge, wound dehiscence, or infection. In our opinion, external expansion with vessel loops followed by a keystone flap might yield fairly good results for the reconstruction of mid-back defects; furthermore, this method may be ideal for defects located in regions lacking sufficient skin laxity.
ISSN:2169-7574