{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T20:49:10Z","timestamp":1791492550581,"version":"4.3.4"},"reference-count":14,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2022,6,4]],"date-time":"2022-06-04T00:00:00Z","timestamp":1654300800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2022,6,4]],"date-time":"2022-06-04T00:00:00Z","timestamp":1654300800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100007551","name":"Hallym University Medical Center","doi-asserted-by":"publisher","award":["HURF\u20102021\u201036"],"award-info":[{"award-number":["HURF\u20102021\u201036"]}],"id":[{"id":"10.13039\/501100007551","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Cosmetic Dermatology"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The keystone perforator flap has become a versatile alternative for reconstruction of cutaneous defects of various etiologies and in all age groups. However, it demands a notable incision area proportional to defect size and is more prone to excessive tension during defect closure. We present a novel modified rotation Hemi\u2010keystone flap that reveals its excellence in flap survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Between March and December 2021, a retrospective chart review was conducted of 40 patients who received rotation Hemi\u2010keystone flap for coverage of cutaneous defects by a single surgeon. The primary outcome was successful flap survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We performed a total of 45 modified rotation Hemi\u2010keystone flaps for reconstruction of cutaneous wound defects. The location of the wound defects was in the head and neck (38%), extremities (35.7%), and trunk (26.2%). The most common cause of wound defect is tumor resection (45.2%). The mean wound defect dimensions were 3.5\u00a0cm\u2009\u00d7\u20093\u00a0cm. The mean follow\u2010up time was 6\u00a0months. There were no significant complications, with only one patient (2.4%) having minor wound dehiscence, which was treated by local wound care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The current series presents a simple, reliable, and versatile modification of the traditional keystone flap that minimizes morbidity at the reconstruction site along with improvement of flap mobility for successful reconstruction of cutaneous defects in a tension\u2010free manner. The favorable outcome of this technique contributes to the inclusion of the rotation Hemi\u2010keystone flap as an excellent surgical option in the reconstruction of various soft tissue defects.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jocd.15111","type":"journal-article","created":{"date-parts":[[2022,5,25]],"date-time":"2022-05-25T12:15:05Z","timestamp":1653480905000},"page":"5819-5824","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Customized reconstruction with rotation\n                    <scp>Hemi\u2010Keystone<\/scp>\n                    flap"],"prefix":"10.1111","volume":"21","author":[{"given":"Mahmoud A.","family":"Hifny","sequence":"first","affiliation":[{"name":"Department of Plastic Surgery, Faculty of Medicine, Qena University Hospital South Valley University  Qena Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tae Hwan","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Dongtan Sacred Heart Hospital Hallym University College of Medicine  Hwaseong Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,6,4]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/1346-8138.14356"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annder.2021.04.006"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000006842"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000008500"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.5999\/aps.2020.00094"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000002228"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0000000000002058"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000002654"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.25879"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/ddg.12542"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0000000000001677"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.13040"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13019-018-0713-x"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocd.13684"}],"container-title":["Journal of Cosmetic Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jocd.15111","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jocd.15111","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jocd.15111","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T19:53:56Z","timestamp":1791489236000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jocd.15111"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,4]]},"references-count":14,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2022,11]]}},"alternative-id":["10.1111\/jocd.15111"],"URL":"https:\/\/doi.org\/10.1111\/jocd.15111","archive":["Portico"],"relation":{},"ISSN":["1473-2130","1473-2165"],"issn-type":[{"value":"1473-2130","type":"print"},{"value":"1473-2165","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6,4]]},"assertion":[{"value":"2022-03-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-05-20","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-06-04","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}