Application of Keystone Design Perforator Island Flap in the Reconstruction of Maxillofacial Defect: A Case Series.

Objective: To investigate the effect of Keystone Design Perforator Island Flap (KDPIF) in the repair of maxillofacial soft tissue defect. Methods: From June 2021 to June 2023, 16 patients with soft tissue defects caused by resection of maxillofacial tumor repaired by KDPIF were selected. Variants of KDPIF were designed according to the area of the defect, and the incision was parallel to the wrinkle as far as possible in the same facial cosmetic subunit. Postoperative follow-up was 3 months to 1 year. Results: One (6.3%) case of flap had dark red congestion and peripheral epidermal necrosis within 1 week. 1 week later, the skin flap blood flow was recovered, and the wound healed after 3 weeks. The other 15 (93.7%) cases of skin flap survived in the first stage. The postoperative follow-up showed that all flaps had good color and shape. There was no obvious scar contracture, the patient was satisfied with the facial shape and had no obvious facial function disorder. Conclusion: KDPIF is easy to operate, with a short operation time, a high survival rate of flap, and a good aesthetic effect, which is especially suitable for the repair of small and medium-sized maxillofacial soft tissue defects in the elderly.