# The Keystone Flap: A Game Changer That Promises New Horizons in Reconstructive Surgery

## TL;DR

The keystone flap is a safe and effective surgical technique for reconstructing soft-tissue defects with minimal complications and high patient satisfaction.

## Contribution

This study provides empirical evidence supporting the keystone flap as an optimal solution for soft-tissue reconstruction.

## Key findings

- The keystone flap had a remarkably low complication rate of 3.22%.
- Patients reported high satisfaction with a score of 9.47 out of 10.
- The flap is suitable for defects of variable sizes and shapes.

## Abstract

Background: Since its first description emerged in 2003, the keystone flap has garnered the attention of the international scientific community due to its high safety profile and the suitably low complication rate associated with the reconstructive process.

Materials and methods: In this study, data were obtained from the performance of 72 keystone flaps to cover soft-tissue defects after the excision of neoplastic processes, excisions, and injuries occurring in polytrauma. The study was conducted in the Department of Plastic Surgery, "Bagdasar-Arseni" Emergency Hospital, Bucharest, and two plastic surgeons in the department performed the surgical procedures.

Results: The statistical analysis revealed a remarkably low complication rate (3.22%), excellent functional and esthetic results, and a short hospitalization time. No intraoperative complications were identified during this study. The degree of satisfaction obtained after reconstructive surgery was exceptionally high, with a score of 9.47 on a 10-point rating scale (0 = poor results, 10 = excellent results) from the patient's perspective and 9.51 out of 10 for the surgical team.

Conclusions: The keystone flap is the optimal solution for reconstructing soft-tissue defects of variable sizes and shapes. It is associated with a low length of hospitalization, a low complication rate, and high patient satisfaction.