Repair of a large lateral foot defect with a combination of keystone island flap and V-Y plasty

Reconstruction of foot defects, not possible with primary closure, is often challenging, because the skin at this level is tight and difficult to mobilize. Traditional random pattern cutaneous flaps also have a limited role for the restoration of small and middle-sized wounds, because of the high risk of complications, such as flap necrosis and dehiscence. Skin grafts are widely used to cover large losses in non-weight-bearing sites, although they tend to heal slowly and result in poor outcomes [1]. [...]