China Journal of Oral and Maxillofacial Surgery ›› 2021, Vol. 19 ›› Issue (5): 460-463.doi: 10.19438/j.cjoms.2021.05.014

• Clinical Reports • Previous Articles     Next Articles

Application of keystone flap in the reconstruction of maxillofacial soft tissue defect:report of 8 consecutive cases

WANG Yi, CHEN Chuan-jun, XIANG Xian-wang   

  1. Centre of Stomatology, First Affiliated Hospital of University of Science and Technology of China. Hefei 230001, Anhui Province, China
  • Received:2021-03-01 Revised:2021-05-25 Online:2021-09-20 Published:2021-10-20

Abstract: PURPOSE: To evaluate the effect of keystone flap in reconstruction of maxillofacial soft tissue defects. METHODS: From January 2019 to June 2020, 8 patients with maxillofacial defects after tumor resection were selected, and keystone flap was designed to reconstruct maxillofacial soft tissue defects. The wound areas ranged from 4 cm×3 cm~15 cm×8 cm; the position and shape of the keystone flap were designed flexibly according to the different defect sites during operation, and the long axis of the keystone flap was consistent with that of the adjacent well-known arteries as far as possible. The central 1/3 of the flap was connected to the base of soft tissue, and the remaining portion of the flap could be properly separated from the base of soft tissue, so that the flap could obtain greater freeness and rotation. RESULTS: All flaps survived and healed primarily in this group.The color and shape of the skin flap recovered well during follow-up from 1 to 6 months. No infection, necrosis and obvious scar contracture were observed, which was acceptable to all patients. No significant impairment of facial function was observed. CONCLUSIONS: Keystone flap rich blood supply, decreased morbidity and effective outcomes, simple to be designed and can satisfy the reconstruction of various minor and medium soft tissue defects in maxillofacial area, which is worthy of clinical application.

Key words: Keystone flap, Perforator, Maxillofacial soft tissue defect, Reconstruction

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