Darrach Halley, Kokosis George, Bridgham Kelly, Stone Jill P, Lange Julie R, Sacks Justin M
Department of Plastic and Reconstructive Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
J Surg Oncol. 2019 Jun;119(7):843-849. doi: 10.1002/jso.25394. Epub 2019 Feb 6.
Two common options for the closure of complex defects are local flaps and skin grafting. The keystone flap, a fasciocutaneous flap based on perforators, has demonstrated compelling ease of use, reproducibility, and low complication rates without requiring a distant donor site. Our objective for this study was to compare postoperative outcomes for keystone flaps and skin grafts in cancer resection.
A retrospective review was conducted of patients undergoing keystone flap closure or skin grafting for soft tissue defects resulting from cancer resection at a single institution from June 2017 to June 2018. Patient demographics, operative indications, length of stay, time to heal, and complications were reviewed.
A total of 34 patients were identified having undergone either keystone reconstruction (n = 16) or skin graft (n = 18) after oncologic resection. Patients undergoing keystone flap reconstruction had significantly shorter mobility restriction and healing times. Length of hospital stay and overall complication rates were not significantly different.
The keystone flap is an adaptable tool that can safely be used for the coverage of complex defects with faster healing, shorter mobility restriction, and comparable complication rates to skin grafting without the need for a distant donor site.
修复复杂缺损的两种常见方法是局部皮瓣和植皮。关键皮瓣是一种基于穿支血管的筋膜皮瓣，已证明其使用简便、可重复性强且并发症发生率低，无需远处供区。本研究的目的是比较关键皮瓣和植皮在癌症切除术后的疗效。
对2017年6月至2018年6月在单一机构因癌症切除导致软组织缺损而接受关键皮瓣修复或植皮的患者进行回顾性研究。回顾了患者的人口统计学资料、手术指征、住院时间、愈合时间和并发症情况。
共确定34例患者在肿瘤切除后接受了关键皮瓣重建（n = 16）或植皮（n = 18）。接受关键皮瓣重建的患者活动受限和愈合时间明显缩短。住院时间和总体并发症发生率无显著差异。
关键皮瓣是一种适应性强的工具，可安全用于修复复杂缺损，愈合更快，活动受限时间更短，并发症发生率与植皮相当，且无需远处供区。
