Al-Mousawi A, Sanese G, Baljer B, et al. - In view of the challenges encountered by clinicians in reconstructing chronic lower extremity wounds particularly when these wounds are complicated by osteomyelitis, researchers here reported their experience using the Keystone Perforator Island Flap following wound and bone debridement as a valuable surgical tool for coverage of complex wounds with bone infection. Similar procedures were performed on 12 patients with overall good outcomes, although a complication, specifically partial flap necrosis and wound dehiscence, occurred in two patients subsequent to recurrent osteomyelitis. Overall outcomes support that for coverage of soft tissue defects and the preservation of bone integrity in the management of patients with chronic osteomyelitis, the Keystone flap method is possibly a safe, reliable, and effective method.