ArticleScientific reports2019
Keystone-design perforator island flaps for the management of complicated epidermoid cysts on the back.
Article in Scientific reports, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 18 citations in OpenAlex.
- The Added Value of Plastic Surgery in the Multidisciplinary Management of Sarcoma Resection: A Multivariable Analysis of Predictors and Postoperative Outcomes.Annals of surgical oncology · 2026Article
- Effect of Suturing and Adhesive Fixation on Free Gingival Graft Stability: An Ex-Vivo Porcine-Model Study.Clinical and experimental dental research · 2026Article
- Retrospective Analysis of 50 Hemi-Keystone Flap Head and Neck Reconstructions with Scar Assessment.Journal of clinical medicine · 2026Article
- Uneasy (Intractable) Head and Neck Defect Coverage With Easy and Reliable Local Flap Techniques: A Retrospective Case-Based Study of Perforator-Plus Peninsular Flap and Modified Keystone Flap.Laryngoscope investigative otolaryngology · 2025Article
- Reconstruction of cervical necrotizing fasciitis defect with the modified keystone flap technique: Two case reports.World journal of clinical cases · 2024Article
- Evaluation of Esthetic Results after Mass Removal with Elliptical Skin Excision Using Ultrasonography to Measure Skin Thickness.Journal of clinical medicine · 2024Article
- Modified Mini-Keystone Flaps for Coverage of Tiny Volar Pulp Defects of the Fingertips in Cases with Missing Amputation Skin Stumps: A Retrospective Study.Journal of clinical medicine · 2022Article
- Modified Keystone Perforator Island Flap for Tension-Reducing Coverage of Axillary Defects Secondary to Radical Excision of Chronic Inflammatory Skin Lesions: A Retrospective Case Series.BioMed research international · 2022Article
- A comparative study for tension-reducing effect of Type I and Type II keystone perforator island flap in the human back.Scientific reports · 2021Article
- Keystone design perforator island flap in facial defect reconstruction.World journal of clinical cases · 2020Review
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Complicated epidermoid cysts (ECs) occur commonly on the back, but few reports have described their management. We present our experience in managing patients with ECs on the back using a keystone-design perforator island flap (KDPIF) reconstruction, thereby focusing on reduction and redistribution of wound tension. Altogether, 15 patients (average age, 48.067 ± 14.868 years) underwent KDPIF reconstructions after complete excision of complicated ECs on the back. We retrospectively reviewed the medical records and clinical photographs of all patients. Final scar appearance was evaluated using the Patient and Observer Scar Assessment Scale (POSAS). All patients had ruptured ECs, while 6 patients also had cellulitis of the surrounding tissues. All defects, after complete excision of ECs and debridement of surrounding unhealthy tissues, were successfully covered with KDPIF. The mean 'tension-change' at the defect and donor sites was -4.73 ± 0.21 N and -4.88 ± 0.25 N, respectively (p < 0.001). The mean 'rate of tension-change' at the defect and donor sites was -69.48 ± 1.7% and -71.16 ± 1.33%, respectively (p < 0.001). All flaps survived with no postoperative complications. The mean observer scar assessment scale (OSAS) summary score and patient scar assessment scale (PSAS) total score were 14.467 ± 5.069 and 15.6 ± 6.512, respectively. Overall, we suggest that KDPIF reconstruction is a good surgical modality for the management of complicated ECs on the back.
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