Modified Keystone Perforator Island Flap for Tension-Reducing Coverage of Axillary Defects Secondary to Radical Excision of Chronic Inflammatory Skin Lesions: A Retrospective Case Series

Figure 4

Clinical photographs (case 8). (a) A chronic inflammatory skin lesion was diagnosed as a complicated epidermoid cyst (EC) in the left axillary pouch. (b) Final defect ( cm²) after radical excision of the lesion and design of a keystone perforator island flap (KPIF) (3.5 × 8.5 cm²) on the medial side of the defect. (c) Successful coverage of the defect using the modified type II KPIF. (d) Postoperative photograph after 5 months of follow-up shows no EC recurrence and a linear scar.

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