RT Journal Article SR Electronic T1 EP1179 Keystone flap application in vulvo-perineal reconstructive surgery: a case series of patients with vulvar cancer JF International Journal of Gynecologic Cancer JO Int J Gynecol Cancer FD BMJ Publishing Group Ltd SP A609 OP A609 DO 10.1136/ijgc-2019-ESGO.1220 VO 29 IS Suppl 4 A1 E Corvetto A1 A Proto A1 M Fais A1 V Locati A1 M Russo A1 A Figus A1 G Candotti A1 V Mais A1 M Peiretti YR 2019 UL http://ijgc.bmj.com/content/29/Suppl_4/A609.1.abstract AB Introduction/Background This study aimed to evaluate the application of Keystone perforator island flaps (KPIF) technique, complications and long-term results in vulvovaginal reconstruction after wide vulvar surgery.Methodology This is the first case series describing the technique of Keystone perforator island flaps to close a wide defect after radical vulvectomy. We prospectively collected patient demographics, operative times, intraoperative, early and late complications, pathologic results, and length of stay on all patients. The benefits, cosmetic results and satisfaction of patients were analyze in the follow up.Results Between December 2016 and July 2018, 5 patients were selected for the study: four patients underwent radical vulvectomy for squamous cell vulvar cancer and one underwent a vulvar wide excision for Paget disease, in all cases a reconstruction with KPIF technique followed the demolitive surgery. The defects were successfully covered by the key stone flap technique in all patients. There were no major intraoperative complications and early postoperative complications such as suture dehiscence occurred in only one patient, suffered a partial dehiscence of the wound. None skin flaps necrosis were observed. All patients were functionally and aesthetically satisfied in the long term.Conclusion Keystone flaps seems to be easy to design, elevate, and offer rapid fasciocutaneous closure in wide vulvo-perineal defect, with few intraoperative, early and late complications and excellent long-term results.Disclosure Nothing to disclose