At the Peter MacCallum Cancer Institute, a tertiary referral oncologic center in Melbourne, Australia, the keystone island flap has been established as a major reconstructive tool for advanced melanoma and other oncologic conditions. With the duet of oncologic and reconstructive surgical teams, the keystone island flap has been the preeminent reconstructive tool for closing large groin defects. There are approximately 18 cases in our series currently being compiled. There have been no cases of total flap loss or partial flap necrosis (one wound dehiscence and one infection). Early cases were reported previously.4
To conclude, Saint-Cyr et al. have produced a useful article on the anatomical basis of the anterolateral thigh fasciocutaneous flap. It explains the success we have enjoyed in keystone island flap reconstruction of groin defects.
Felix C. Behan, M.B.B.S.
Cheng Hean Lo, M.B.B.S.
Michael Findlay, M.B.B.S.
1. Saint-Cyr M, Schaverien M, Wong C, et al. The extended anterolateral thigh flap: Anatomical basis and clinical experience. Plast Reconstr Surg.
2. Behan FC, Wilson I. The principle of the angiotome, a system of linked axial pattern flaps. In: Transactions of the 6th International Congress of Plastic and Reconstructive Surgery.
Paris: Masson; 1975
3. Behan FC. The keystone design perforator island flap in reconstructive surgery. ANZ J Surg.
4. Behan F, Sizeland A, Porcedu S, Somia N, Wilson J. Keystone island flap: An alternative reconstructive option to free flaps in irradiated tissue. ANZ J Surg.
Letters to the Editor, discussing material recently published in the Journal, are welcome. They will have the best chance of acceptance if they are received within 8 weeks of an article's publication. Letters to the Editor may be published with a response from the authors of the article being discussed. Discussions beyond the initial letter and response will not be published. Letters submitted pertaining to published Discussions of articles will not be printed. Letters to the Editor are not usually peer reviewed, but the Journal may invite replies from the authors of the original publication. All Letters are published at the discretion of the Editor.
Authors will be listed in the order in which they appear in the submission. Letters should be submitted electronically via PRS' enkwell, at www.editorialmanager.com/prs/.
We reserve the right to edit Letters to meet requirements of space and format. Any financial interests relevant to the content of the correspondence must be disclosed. Submission of a Letter constitutes permission for the American Society of Plastic Surgeons and its licensees and asignees to publish it in the Journal and in any other form or medium.
The views, opinions, and conclusions expressed in the Letters to the Editor represent the personal opinions of the individual writers and not those of the publisher, the Editorial Board, or the sponsors of the Journal. Any stated views, opinions, and conclusions do not reflect the policy of any of the sponsoring organizations or of the institutions with which the writer is affiliated, and the publisher, the Editorial Board, and the sponsoring organizations assume no responsibility for the content of such correspondence.