{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:46:22Z","timestamp":1787755582001,"version":"build-2784847793"},"reference-count":13,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Case:<\/jats:title>\n                    <jats:p>A 61-year-old patient was referred 12 days postoperative with complex, infected, and dehisced paraspinal wound. After debridement and revision of hardware, deep dead space was eliminated through bilateral paraspinal muscle flap advancement. After hardware coverage, a large skin and tissue defect remained. The defect was reconstructed using a modified Keystone flap, eliminating the lateral cutaneous incision. Our patient healed without complication.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The modified Keystone flap is an option for reconstructing spinal wound defects, yielding excellent tissue coverage and advancement, grants additional flap advancement if necessary because of elimination of the lateral cutaneous incision, and an overall pleasing aesthetic result.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.cc.20.00128","type":"journal-article","created":{"date-parts":[[2020,12,24]],"date-time":"2020-12-24T16:02:52Z","timestamp":1608825772000},"page":"e20.00128","source":"Crossref","is-referenced-by-count":0,"title":["Reconstructing Complex Open Back Wounds with a Modified Minimal-Access Keystone Flap"],"prefix":"10.2106","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1757-8410","authenticated-orcid":false,"given":"Spencer R.","family":"Anderson","sequence":"first","affiliation":[{"name":"Department of Plastic Surgery, Wright State University Boonshoft School of Medicine, Dayton, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0175-7956","authenticated-orcid":false,"given":"Kyle M.","family":"Rako","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7985-6204","authenticated-orcid":false,"given":"Sunishka M.","family":"Wimalawansa","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Wright State University Boonshoft School of Medicine, Dayton, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020]]},"reference":[{"issue":"8","key":"bib1-20230719","doi-asserted-by":"crossref","first-page":"883","DOI":"10.1016\/j.bjps.2007.01.072","article-title":"The keystone design perforator island flap. 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