Weinberg Maxene, Heiman Adee J, DeSanti Rebecca, Lanni Michael A, Kouwenberg Emily Van, Patel Ashit
Division of Plastic Surgery, Albany Medical College, Albany, New York.
Division of Plastic Surgery, University of Washington, Seattle, Washington.
J Reconstr Microsurg. 2022 Nov;38(9):727-733. doi: 10.1055/s-0042-1745744. Epub 2022 Apr 27.
The Keystone Design Perforator Island Flap (KDPIF), first described by Behan in 2003, has been demonstrated as a versatile, safe, and straightforward reconstructive option for various soft tissue defects. The purpose of this systematic review is to evaluate the indications, variations, and overall complication profile of the keystone flap in reconstructive surgery.
A literature review was conducted in accordance with PRISMA guidelines using MeSH term "surgical flaps" with the keyword "keystone flap." Empirical studies with at least 15 patients who underwent keystone flap reconstruction were assessed for quantitative analysis. Outcomes of interest included patient demographics, indications, anatomic location, flap design, and complications.
Database search produced 135 articles, of which 25 were selected for full-text review. Out of 23 studies selected qualitative analysis and 22 met criteria for quantitative analysis. Overall success rate of this flap was 98%. Wound complications were highest in extremity flaps. Several modifications of this flap were described.
Keystone reconstruction demonstrates excellent success rates and versatility. However, further studies with more standard reporting are needed to determine guidelines for patient specific surgical planning.
基石设计穿支岛状皮瓣（KDPIF）由贝汉于2003年首次描述，已被证明是一种用于各种软组织缺损的通用、安全且简便的重建选择。本系统评价的目的是评估基石皮瓣在重建手术中的适应证、变异情况及总体并发症情况。
按照PRISMA指南进行文献综述，使用医学主题词“外科皮瓣”及关键词“基石皮瓣”。对至少15例接受基石皮瓣重建手术患者的实证研究进行定量分析评估。感兴趣的结果包括患者人口统计学特征、适应证、解剖位置、皮瓣设计及并发症。
数据库检索产生135篇文章，其中25篇被选作全文综述。在所选的23项研究中进行定性分析，22项符合定量分析标准。该皮瓣的总体成功率为98%。伤口并发症在四肢皮瓣中最高。描述了该皮瓣的几种改良方法。
基石重建显示出极高的成功率和通用性。然而，需要进行更多标准报告的进一步研究，以确定针对特定患者手术规划的指南。
