{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T22:26:00Z","timestamp":1785450360151,"version":"3.56.0"},"reference-count":21,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2017,12,1]],"date-time":"2017-12-01T00:00:00Z","timestamp":1512086400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The International Journal of Lower Extremity Wounds"],"published-print":{"date-parts":[[2017,12]]},"abstract":"<jats:p>\n                    Reconstruction of pretibial skin and soft-tissue defects remains a challenge because this area has less underlying tissues and limited tissue mobility. Here, we present a retrospective review of our experience with pretibial reconstruction using the keystone-designed perforator island flap (KDPIF) in patients with comorbidities. All defects resulted from nononcological causes. We describe the expanding versatility of KDPIF reconstruction for pretibial defects and suggest a simple algorithmic approach. The medical records of 9 patients who underwent reconstruction with a KDPIF to cover a pretibial defect between May 2016 and June 2017 were reviewed. Clinical and operative data were collected. All 9 KDPIFs fully survived. The defect size varied from 3 \u00d7 2 cm\n                    <jats:sup>2<\/jats:sup>\n                    to 8 \u00d7 6 cm\n                    <jats:sup>2<\/jats:sup>\n                    . The flap size varied from 5 \u00d7 3 to 20 \u00d7 10 cm\n                    <jats:sup>2<\/jats:sup>\n                    . The mean operative time was 90.4 minutes (range = 37-127 minutes). No postoperative complications occurred. The cosmetic results were favorable, and all patients were satisfied with the final outcomes. Thus, the KDPIF is a good reconstruction modality with few complications and provides an alternative to free flaps for pretibial defect reconstruction in patients with comorbidities.\n                  <\/jats:p>","DOI":"10.1177\/1534734617740971","type":"journal-article","created":{"date-parts":[[2017,12,18]],"date-time":"2017-12-18T08:47:45Z","timestamp":1513586865000},"page":"302-309","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":25,"title":["Keystone-Designed Perforator Island Flaps for the Coverage of Traumatic Pretibial Defects in Patients With Comorbidities"],"prefix":"10.1177","volume":"16","author":[{"given":"Chi Sun","family":"Yoon","sequence":"first","affiliation":[{"name":"Department of Plastic and Reconstructive surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sang Il","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive surgery, Konyang University Hospital, University of Konyang College of Medicine, Metropolitan City Daejeon, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hoon","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive surgery, Konyang University Hospital, University of Konyang College of Medicine, Metropolitan City Daejeon, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyu Nam","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive surgery, Konyang University Hospital, University of Konyang College of Medicine, Metropolitan City Daejeon, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2017,12,18]]},"reference":[{"key":"bibr1-1534734617740971","doi-asserted-by":"publisher","DOI":"10.5999\/aps.2012.39.4.360"},{"key":"bibr2-1534734617740971","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3181904dc4"},{"key":"bibr3-1534734617740971","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0b013e3181ac4263"},{"key":"bibr4-1534734617740971","doi-asserted-by":"publisher","DOI":"10.1055\/s-0034-1369807"},{"key":"bibr5-1534734617740971","doi-asserted-by":"publisher","DOI":"10.1186\/s40064-016-1714-7"},{"key":"bibr6-1534734617740971","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2016.09.028"},{"key":"bibr7-1534734617740971","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3181cb675f"},{"key":"bibr8-1534734617740971","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3181c2a4c9"},{"key":"bibr9-1534734617740971","doi-asserted-by":"publisher","DOI":"10.1046\/j.1445-2197.2003.02638.x"},{"key":"bibr10-1534734617740971","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e318205f36f"},{"key":"bibr11-1534734617740971","first-page":"PC05","volume":"9","author":"Rao 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