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The ‘keystone concept’: time for some science
Author(s) -
Douglas Charles,
Morris Owen
Publication year - 2013
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.12291
Subject(s) - keystone species , medicine , ecology , biology , ecosystem
The keystone flap closure is a surgical innovation that has been enthusiastically embraced by many surgeons. However, we think a genuinely critical appraisal has been lacking. The keystone closure appears fundamentally different from other flap closures, but the rationale has been only vaguely described, while claims about biomechanics have been anecdotal. The development of substantially different ‘variations’ suggests that there is no shared understanding about what manoeuvres matter and why