Free flaps for reconstruction of soft tissue defects in lower extremity: A meta-analysis on microsurgical outcome and safety

Background Microsurgical free flaps for reconstruction of soft tissue defects in lower extremity have evolved into a reliable procedure over last decades; however, there lacked high level of evidence. Methods A systematic literature research was performed including studies between 2000 and 2014 in E...

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Hauptverfasser: Xiong, Lingyun (VerfasserIn) , Kremer, Thomas (VerfasserIn) , Hernekamp, Jochen-Frederick (VerfasserIn) , Harhaus-Wähner, Leila (VerfasserIn) , Kneser, Ulrich (VerfasserIn) , Hirche, Christoph (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 05 January 2016
In: Microsurgery
Year: 2016, Jahrgang: 36, Heft: 6, Pages: 511-524
ISSN:1098-2752
DOI:10.1002/micr.30020
Online-Zugang:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1002/micr.30020
Verlag, lizenzpflichtig, Volltext: https://onlinelibrary.wiley.com/doi/abs/10.1002/micr.30020
Volltext
Verfasserangaben:Lingyun Xiong, Emre Gazyakan, Thomas Kremer, Frederick J. Hernekamp, Leila Harhaus, Michel Saint-Cyr, Ulrich Kneser, and Christoph Hirche

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520 |a Background Microsurgical free flaps for reconstruction of soft tissue defects in lower extremity have evolved into a reliable procedure over last decades; however, there lacked high level of evidence. Methods A systematic literature research was performed including studies between 2000 and 2014 in English, German, and Chinese (PubMed, EMBASE). Publications were selected applying inclusion/exclusion criteria. Postoperative complications were statistically analyzed with metaprop command of R GUI 3.0.1. Results Alltogether 30 articles overlooking 1,397 free flaps were included. The rate of total flap loss was 6.0% (95% confidence interval [CI] = 4.0%-8.0%, PQ (P values of Q statistics) = 0.03); the thrombosis rate was 6.0% (95% CI = 4.0%-9.0%, PQ = 0.01); the hematoma rate was 4.0% (95% CI = 3.0%-5.0%, PQ = 0.79); the partial necrosis rate was 6.0% (95% CI = 4.0%-10.0%, PQ < 0.01); the early infection rate was 4.0% (95% CI = 2.0%-6.0%, PQ = 0.03), and the dehiscence rate was 3.0% (95% CI = 2.0%-5.0%, PQ = 0.12). Reconstruction for diabetic foot may be not associated with a significant increase of procedural risk (Total flap loss rate = 6%, 95% CI = 3.0%-9.0%, PQ = 0.44). Conclusions Microsurgical reconstruction of soft tissue defects in the lower extremity reconstruction could be regarded safe and reliable. A standardization of report of perioperative parameters and clinical outcomes is needed. 
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