PMC9831175_01
The 14 cm x 8 cm defect on the posterior left arm after wide excision with a margin of 0.5 cm.
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F1
The dimension of the skin and soft tissue defect was 14 cm x 8 cm, resulting in exposition of the posterior brachial fascia covering the triceps brachii muscle (Figure 1).
Postresection defect and design of a keystone flap type I.
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F2
After histological confirmation of in sano resection, the authors planned and performed a reconstruction with a keystone type I flap (Figure 2).
The defect was successfully covered with the keystone type I flap and a 3 cm x 2 cm EpiGARD (Biovision GmbH, Ilmenau, Germany).
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F3
The authors then partially released the sutures, creating a residual defect of 3 cm x 2 cm, and used an EpiGARD for temporary closure (Figure 3).
Results at 6-month postoperative follow-up.
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F4
The result was satisfactory with a pleasing cosmetic result after an 8-month follow-up (Figure 4).