ArticleScientific reports2021
A comparative study for tension-reducing effect of Type I and Type II keystone perforator island flap in the human back.
Article in Scientific reports, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 12 citations in OpenAlex.
- [Clinical application of a modified double keystone design perforator island flap for repair of defects after excision of Bowen disease in posterior midline lumbar region].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 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
- Patient and Observer Scar Assessment of Facial Keystone Flap Reconstruction in Korean Patients.Journal of clinical medicine · 2025Article
- 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
- Optimizing Primary Closure of Anterolateral Thigh Flap Donor Sites Through Literature Review and Clinical Analysis.Plastic and reconstructive surgery. Global open · 2025Article
- Modified Keystone a Versatile Flap Reconstruction for Mastectomy Defects: Our Clinical Experience.Indian journal of plastic surgery : official publication of the Association of Plastic Surgeons of India · 2025Article
- Versatility of the Keystone Design Perforator Island Flaps in Resurfacing Soft Tissue Defects.Indian journal of plastic surgery : official publication of the Association of Plastic Surgeons of India · 2024Article
- Experimental investigation of tension-reducing effectiveness of keystone perforator island flap.Medicine and pharmacy reports · 2024Article
- Reconstruction of cervical necrotizing fasciitis defect with the modified keystone flap technique: Two case reports.World journal of clinical cases · 2024Article
- Modified Keystone Perforator Island Flap Techniques for Small- to Moderate-Sized Scalp and Forehead Defect Coverage: A Retrospective Observational Study.Journal of personalized medicine · 2023Article
- 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
- Vessel Loop Shoelace Technique followed by Keystone Flap to Treat a Large Mid-back Defect.Plastic and reconstructive surgery. Global open · 2022Article
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Authors and funding
6 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The keystone perforator island flap (KPIF) is popular in reconstructive surgery. However, despite its versatility, its biomechanical effectiveness is unclear. We present our experience of KPIF reconstruction in the human back and evaluate the tension-reducing effect of the KPIF. Between September 2019 and August 2020, 17 patients (51.82 ± 14.72 years) underwent KPIF reconstruction for back defects. In all cases, we measured wound tension at the defect and donor sites before and after KPIF reconstruction using a tensiometer. All defects occurred after complete excision of complicated epidermoid cysts and debridement of surrounding tissues. The defects were successfully covered with Type IIA KPIFs. All flaps survived, and there were no significant postoperative complications. The mean "tension change at the defect after Type I KPIF" and "tension change at the defect after Type II KPIF" were - 2.97 ± 0.22 N and - 5.59 ± 0.41 N, respectively, (P < 0.001). The mean "rate of tension change at the defect after Type I KPIF" and "rate of tension change at the defect after Type II KPIF" were - 36.54 ± 1.89% and - 67.98 ± 1.63%, respectively, (P < 0.001). Our findings confirm the stepwise tension-reducing effect of KPIF and clarify the biomechanics of this flap.
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