Clinical application of keystone design perforator Island flap (KDPIF) in trunk defects: a retrospective study

Abstract

The aim of this study was to evaluate the treatment outcomes of patients with trunk defects reconstructed by Keystone Design Perforator Island Flap (KDPIF). A total of 37 eligible cases with trunk defects were reconstructed by KDPIF from January 2017 to June 2020. Data were collected from electronic medical records, including aetiology, defect size and location, and type of KDPIF applied. Postoperative complications were recorded, and patient satisfaction was evaluated at the last clinical visit. There were 23 males and 14 females, and the average defect was 8.16 × 4.94 cm. Etiologies included decubitus ulcer (n=12), oncologic resection (n=11), infection (n=9) and others (n=5). Type III was applied in 19 cases, Type IIa in 13 cases, type IV in two cases and modified KDPIF in three cases. There were no major complications except delayed healing or wound dehiscence in three cases, which were managed by regular dressing or secondary surgical intervention. The average postoperative satisfaction score was 8.68 ± 1.13 points and all patients were satisfied with their cosmetic appearance and function at the last follow-up. Trunk defects can be successfully reconstructed by KDPIF, which results in satisfactory cosmetic and functional outcomes without major complications.