Keystone Island Flap for Reconstructive Surgery—A Novel Approach

Keystone island flaps have a growing array of applications in reconstructive surgeries for the closure of simple and complex defects following the excision of skin tumors. It is a trapezoidal-shaped flap based on fasciocutaneous perforators. We share our experience with a 79-year-old man, who underwent keystone island flap reconstruction after the excision of biopsy-proven Bowen’s disease. A good aesthetic and functional outcome was obtained. With an ever expanding repertoire of reconstructive surgical techniques, the individualization of defect closure is of paramount importance in ensuring good cosmesis.