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

ABSTRACT: 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.

SUBMITTER: Lee CC

PROVIDER: S-EPMC8785938 | biostudies-literature | 2022 Jan

REPOSITORIES: biostudies-literature

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

Lee Chia-Chun CC Wang Tien-Hsiang TH Chen Ching-En CE

Plastic and reconstructive surgery. Global open 20220124 1

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 w ...[more]

PMID: 35083103

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