Background: In reconstructive surgery, the perforator flap procedure involves removing skin and/or subcutaneous fat from a distant or nearby portion of the body in order to restore the excised part. Isolated perforators from a deep vascular system are what provide the flap its blood supply. The trapezoidal-shaped keystone perforator island flap is effectively two linked V-Y island flaps.

Objectives: we aimed in this study to determine the feasibility and safety of keystone island flap in managing various limb defects.

Patients and Methods: Patients who presented to the plastic surgery department at the Suez Canal University Hospital with leg deformities were the subject of a planned cross-sectional study. 15 patients were included in the study; 10 (66.67%) men and 5 (33.33%) women had soft tissue leg abnormalities. Patients underwent a history-taking process that included gathering information about their demographics, medical histories, comorbidities, and surgical indications. Defect characteristics and placements were also evaluated, as were hospitalization and sequelae.

Results: The lengths of the faults ranged from 1 cm to 5 cm, with a p-value < 0.001. There were substantial relationships between the actual means of the score's component components and the samples of their respective variables, according to the descriptive statistics of the POSAS Observer scale and its constituents' mean scores (p-value < 0.001). Regarding the population of the study, there was a statistically significant variation in the distribution of problems. The remaining two patients (Fisher's test's p-value = 0.001) showed one or more difficulties, while the remaining 13 patients did good.