A very few flaps would be described as versatile as the Keystone Flap. The flap was described by Behan in 2003. The keystone flap derives its name from its similarity to the architectural keystone piece that marks the central portion of the arch. It employs immediately adjacent skin and soft tissue that provides a good colour match in addition to reconstructing the contour of the defect, so providing a far superior cosmetic result. A prospective study was developed from October 2017 to December 2019 at SMS Hospital, Jaipur. In our experience, we have observed flap execution is easier over the trunk, gluteal region and thigh, but difficult over knee and distal leg due to deficient skin laxity in the lower leg. It is an excellent option for covering large defects over the thigh where there is adequate tissue laxity. It is a safe option for conditions where microsurgery may not be a viable option. The relative simplicity of this flap makes it to go option at many places.
Samarth Gupta*, Abhishek Sharma and Sunil Srivastava