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Keystone Flap: Overcoming Paradigms

BACKGROUND: The physiology and geometry of the keystone flap (KF) are the main factors that support its development. This study reports our experience using the KF and proposes the concept of pedicular area. METHODS: A prospective cohort study was conducted from October 2014 to December 2016, in whi...

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Autores principales: Gómez, Oswaldo J., Barón, Oscar I., Peñarredonda, Martha L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6467614/
https://www.ncbi.nlm.nih.gov/pubmed/31044108
http://dx.doi.org/10.1097/GOX.0000000000002126
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author Gómez, Oswaldo J.
Barón, Oscar I.
Peñarredonda, Martha L.
author_facet Gómez, Oswaldo J.
Barón, Oscar I.
Peñarredonda, Martha L.
author_sort Gómez, Oswaldo J.
collection PubMed
description BACKGROUND: The physiology and geometry of the keystone flap (KF) are the main factors that support its development. This study reports our experience using the KF and proposes the concept of pedicular area. METHODS: A prospective cohort study was conducted from October 2014 to December 2016, in which 112 KF procedures were performed with an average follow-up time of 10 months. The conclusions drawn from clinical observations were compared with the findings of a literature review. RESULTS: One hundred twelve flaps were performed in 89 patients (45 men and 44 women) with an average age of 64 years (range, 3–89 years). The flap survival rate was 100%. The term pedicular area (PA) was coined to describe a flap segment that remains attached to its bed without vascular detriment and whose location can be randomly selected. In this study, the PA could be reduced up to a 10%, which means that over 90% of each flap was dissected without any harm. CONCLUSIONS: The KF is a safe, cost-effective technique with better results when compared with other reconstructive procedures. Although research is still needed to better understand the physiological adaptations of KF, the clinical evidence supports its use in many reconstructive scenarios.
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spelling pubmed-64676142019-05-01 Keystone Flap: Overcoming Paradigms Gómez, Oswaldo J. Barón, Oscar I. Peñarredonda, Martha L. Plast Reconstr Surg Glob Open Original Article BACKGROUND: The physiology and geometry of the keystone flap (KF) are the main factors that support its development. This study reports our experience using the KF and proposes the concept of pedicular area. METHODS: A prospective cohort study was conducted from October 2014 to December 2016, in which 112 KF procedures were performed with an average follow-up time of 10 months. The conclusions drawn from clinical observations were compared with the findings of a literature review. RESULTS: One hundred twelve flaps were performed in 89 patients (45 men and 44 women) with an average age of 64 years (range, 3–89 years). The flap survival rate was 100%. The term pedicular area (PA) was coined to describe a flap segment that remains attached to its bed without vascular detriment and whose location can be randomly selected. In this study, the PA could be reduced up to a 10%, which means that over 90% of each flap was dissected without any harm. CONCLUSIONS: The KF is a safe, cost-effective technique with better results when compared with other reconstructive procedures. Although research is still needed to better understand the physiological adaptations of KF, the clinical evidence supports its use in many reconstructive scenarios. Wolters Kluwer Health 2019-03-14 /pmc/articles/PMC6467614/ /pubmed/31044108 http://dx.doi.org/10.1097/GOX.0000000000002126 Text en Copyright © 2019 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Original Article
Gómez, Oswaldo J.
Barón, Oscar I.
Peñarredonda, Martha L.
Keystone Flap: Overcoming Paradigms
title Keystone Flap: Overcoming Paradigms
title_full Keystone Flap: Overcoming Paradigms
title_fullStr Keystone Flap: Overcoming Paradigms
title_full_unstemmed Keystone Flap: Overcoming Paradigms
title_short Keystone Flap: Overcoming Paradigms
title_sort keystone flap: overcoming paradigms
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6467614/
https://www.ncbi.nlm.nih.gov/pubmed/31044108
http://dx.doi.org/10.1097/GOX.0000000000002126
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