[The modified keystone perforator island flap for reconstruction of skin defects at head and face].

Objective: To investigate the clinical application of the modified keystone perforator island flap for reconstruction of skin defects at head and face.

Methods: From January 2013 to September 2014,13 cases with skin defects at head and face were repaired by modified keystone perforator island flap. The skin defects ranged from 0.8 cm× 1.0 cm to 20.0 cm × 10.0 cm. And the flap size ranged from 1.5 cm × 1.0 cm to 22.0 cm × 12.0 cm. The flap was designed along the edge of the defect, the vascular supply was supported by muscular perforators. In order to relieve suture tension and have a good cosmetic effect, auxiliary incisions should be as less as possible. Flap should be designed to hide parts of facial incision or surgical margins within the natural borders of each facial unit, or along the direction of striae. Incision within the hairline should be taken to minimize damage to the hair follicles. The direction of hair growth shouldn't be changed after the flap transfer.

Results: All cases had 1-12 months' follow-up period.12 flaps survived completely, with one partial flap necrosis. The flaps had good appearance with high aesthetic satisfactory.

Conclusions: The modified keystone perforator island flap produces excellent aesthetic results. It can be a very useful flap for the individual reconstruction of skin defects at head and face.