Case	Location	Summary
1	Neck	Introduction to using KPIF with melanoma posterior neck.
2	Neck	Neck melanoma and the KPIF design within the c2 c3 dermatomes undermining leaving a third attachment along sternocleidomastoid muscle: no Doppler localisation.
3	Neck	Neck, anterior infraclavicular random perforators for the KPIF.
4	Scalp	Scalp—vertex melanoma of the scalp, secondary disseminated into the right neck—following clearance the cyanotic flap is hypervascularised by creating an island leaving a third deep attachment. Full survival.
5	Calf	Melanoma—lower limb over posterior calf above the tendo achilles.
6	Face	Face—preauricular region melanoma closure with a cervico submental KPIF. Base rotated on random sternocleidomastoid perforator
7	Hand	Hand—first dornal interosseous region melanoma—poor biopsy orientation closure with a circumferential KPIF with hand in ulna deviation.
8	Face	Right cheek melanoma—closure with a submandibular KPIF closure.
9	Face	Right cheek melanoma—parodid melanoma defect 10 x 9 cm closure by supraclavicular KPIF with a third attached beyond the block dissection.
10	Face	Right cheek melanoma in an irradiated field—KPIF can be used in irradiated field reflecting the hyperaemic phase in spite of subdermal fibrosis caused by the xrt, the vertical orientated perforators bypass this fibrosis to ensure healing.
11	Partoid	Right parotid melanoma—direct closure smas layer KPIF.
12 and 13	Groin	Groin—recurrent melanoma following failed xrt. Primary acral lentiginous melanoma on the sole of the foot. The quadrangular l2 KPIF of the anterior thigh closes the defect after division tensor fascia and medial deep fascia KPIF.
14	Calf	Lateral calf—melanoma—grafting of the secondary defect in along the peroneal compartment because of tension.
15	Calf	Left calf upper third—peroneal KPIF creating a horse shoe variant—u shape—and preservation of the superficial peroneal nerve and split skin graft of secondary defect.
16	Jaw	Angle of the jaw—large melanoma over the parotid. Closure of the defect with a cervico submental KPIF.
17	Jaw	Angle of the jaw—melanoma of the parotid in an 80–year–old, closure by creating island KPIF by delineating the v2 dermatome to hypervascularise it. The whole wound is closed directly including tensional apposition over the parotid.
18	Face	HMF l 1mm of the left cheek—drape procedure, delayed reconstruction after pathology evaluation. Clearance and closure of the cervico submental KPIF based on random sternocleidomastoid perforators.
19	Calf	Calf melanoma—the standard for learning the art of the KPIF closure over muscles. Calf, thigh, forearm and biceps region are the easiest places to learn this KPIF technique (deep fascia must be divided to create a bridge flap).
20	Face	Right malar melanoma—superior orientation of the KPIF along the v2 division delineation allows direct apposition as an alternative to a cheek rotation flap in a young patient.
21	Calf	Right calf—standard KPIF in a young female—orientated according to the biopsy orientation—single redivac drain tube covering both sites is folded on itself—draining both defects
22	Foot	Heel acral lentiginous melanoma in an 80–year–old patient, planta fascia KPIF. Based on medial planta neurovascular circuit leaving the medial third attachment for the KPIF, no secondary defect graft needed, although planned.
23	Scapula	Scapula region melanoma—sarcamo of the scapula with auxillary clearance—omega KPIF fascial lined variant leaving the middle third attached to t6–t8 intercostal perforators orientation. Patient walked the himalayas 4–5 weeks post–op.
24	Partoid	Recurrent melanoma of the parotid— sacrificing the facial nerve. KPIF principle and v2 dermatome is the mark out for the island flap reconstruction to hyper vascularise the cyanotic tip. Delayed tarsorrhaphy 12months.
25	Head	Forehead melanoma and reconstruction with v2 dermatome islanded flap to hyper vascularise the tip, to reach the medial eyebrow region for a defect 10 x 6 cm.
26	Head	Left forehead desmoplastic melanoma. KPIF of the superficial temporal artery in a smoker. The sarcoma clearance was achieved, but this may contributed to the distal flat necrosis which took 4 weeks to heal. Complication
27	Calf	Complications of the calf—delayed healing in a KPIF for recurrent melanoma following xrt, then groin dissection and peripheral oedema.
28	Head	Forehead melanoma—slow healing KPIF in a patient with chronic lymphatic leukaemia.

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