{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,12]],"date-time":"2026-11-12T19:50:34Z","timestamp":1794513034946,"version":"4.9.1"},"reference-count":16,"publisher":"Baishideng Publishing Group Inc.","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World J Clin Cases"],"abstract":"<jats:p>BACKGROUND<\/jats:p>\n          <jats:p>Cervical necrotizing fasciitis (CNF) is a rare, aggressive form of deep neck space infection with significant morbidity and mortality rates. Serial surgical debridement acts as the cornerstone of CNF treatment; however, it often results in defects requiring complex reconstructions.<\/jats:p>\n          <jats:p>CASE SUMMARY<\/jats:p>\n          <jats:p>We report two cases in which the keystone flap (KF) was used for CNF defect coverage: Case 1, an 85-year-old patient with CNF in the anterior neck, and Case 2, a 54-year-old patient with CNF in the posterior neck. Both patients received empirical intravenous antibiotic therapy and underwent serial debridement, enabling adequate wound preparation and stabilization. The final defect size measured 5.5 cm \u00d7 12 cm in Case 1 and 6 cm \u00d7 11 cm in Case 2. For defect coverage, we employed an 8 cm \u00d7 19 cm type II KF based on perforators from the superior thyroid artery in Case 1 and a 9 cm \u00d7 18 cm type II KF based on perforators from the transverse cervical artery in Case 2. Both flaps showed complete survival. No postoperative complications occurred in both cases, and favorable outcomes were observed at 7- and 6-month follow-ups in case 1 and 2, respectively.<\/jats:p>\n          <jats:p>CONCLUSION<\/jats:p>\n          <jats:p>We effectively treated CNF-associated defects using the KF technique; KF is viable for covering CNF defects in carefully selected cases.<\/jats:p>","DOI":"10.12998\/wjcc.v12.i7.1305","type":"journal-article","created":{"date-parts":[[2024,2,29]],"date-time":"2024-02-29T08:36:10Z","timestamp":1709195770000},"page":"1305-1312","source":"Crossref","is-referenced-by-count":4,"title":["Reconstruction of cervical necrotizing fasciitis defect with the modified keystone flap technique: Two case reports"],"prefix":"10.12998","volume":"12","author":[{"given":"Wonseok","family":"Cho","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eun A","family":"Jang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyu Nam","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2060","published-online":{"date-parts":[[2024,3,6]]},"reference":[{"key":"B1","unstructured":"Yang YS, Lee HU, Kim JS, Lee JK, Hong KH. A clinical study of the cervical necrotizing fasciitis. Korean J Otorhinolaryngol-Head Neck Surg 2005; 48: 1020-1026"},{"key":"B2","unstructured":"Kim CH, Choung YH, Oh JH, Lee JW. Management of cervical necrotizing fasciitis. Korean J Otorhinolaryngol-Head Neck Surg 2005; 48: 771-777"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1177\/0145561321991341"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.32382"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.20408\/jti.2020.0025"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2014.00036"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1002\/hed.25184"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000007581"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.3390\/jpm13020329"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1093\/jscr\/rjad127"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-019-51289-4"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-96272-0"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2012.08.027"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1007\/s12262-015-1406-5"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2007.03.023"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1155\/2022\/5600450"}],"container-title":["World Journal of Clinical Cases"],"original-title":[],"link":[{"URL":"https:\/\/www.wjgnet.com\/2307-8960\/full\/v12\/i7\/1305.htm","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.wjgnet.com\/2307-8960\/full\/v12\/i7\/1305.htm","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,29]],"date-time":"2024-02-29T08:38:13Z","timestamp":1709195893000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.wjgnet.com\/2307-8960\/full\/v12\/i7\/1305.htm"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,6]]},"references-count":16,"journal-issue":{"issue":"7"},"URL":"https:\/\/doi.org\/10.12998\/wjcc.v12.i7.1305","relation":{},"ISSN":["2307-8960"],"issn-type":[{"value":"2307-8960","type":"print"}],"subject":[],"published":{"date-parts":[[2024,3,6]]}}}