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A comparison of postoperative outcomes based on recipient vessels in scalp free flap reconstruction: A systematic review and meta-analysis.
Pekcan, Asli; Roohani, Idean; Stanton, Eloise; Choe, Deborah; Tomaro, Micaela; Premaratne, Ishani D; Wallace, Langley G; Carey, Joseph N; Daar, David A.
Afiliación
  • Pekcan A; Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
  • Roohani I; Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
  • Stanton E; Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
  • Choe D; Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
  • Tomaro M; Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
  • Premaratne ID; Division of Plastic and Reconstructive Surgery, Keck School of Medicine of USC, Los Angeles, California, USA.
  • Wallace LG; Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
  • Carey JN; Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
  • Daar DA; Division of Plastic and Reconstructive Surgery, Keck School of Medicine of USC, Los Angeles, California, USA.
Microsurgery ; 44(5): e31211, 2024 Jul.
Article en En | MEDLINE | ID: mdl-38994707
ABSTRACT

PURPOSE:

The superficial temporal artery (STA) and facial artery (FA) are two commonly used recipient vessels when performing free tissue transfer to the head and neck. This meta-analysis compares the impact of recipient vessel location on free flap outcomes in scalp reconstruction.

METHODS:

A systematic review was conducted following PRISMA-P guidelines using six databases. Studies reporting free tissue transfer using the STA or FA as a recipient vessel for reconstructing scalp defects were included. Outcomes of interest included flap loss, partial flap necrosis, wound dehiscence, venous thrombosis, and infection rates. Quality evaluation was performed using ASPS criteria and the ROBINS-I tool.

RESULTS:

Of 3270 identified articles, 12 were included for final analysis. In total, 125 free flaps were identified (75 STA, 50 FA). Pooled analysis demonstrated an overall flap survival rate of 98.4% (STA 98.7% vs. FA 98.0%; p = .782). The mean defect size was significantly greater for flaps using the STA compared with the FA (223.7 ± 119.4 cm2 vs. 157.1 ± 96.5 cm2, p = .001). The FA group had a higher incidence of wound dehiscence than the STA group (14.0% vs. 1.3%, p = .005). However, meta-analysis demonstrated no significant difference in rates of wound dehiscence, flap loss, partial flap necrosis, venous congestion, or postoperative infection between groups.

CONCLUSION:

This is the first systematic review and meta-analysis to assess recipient vessel selection in scalp reconstruction. Our results do not support a single vessel as the superior choice in scalp reconstruction. Rather, these findings suggest that the decision between using the STA or FA is multifaceted, requiring a flexible approach that considers the individual characteristics of each case. Further research is needed to explore additional factors influencing recipient vessel selection, including defect location, radiation therapy, and prior head and neck surgery.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cuero Cabelludo / Arterias Temporales / Procedimientos de Cirugía Plástica / Colgajos Tisulares Libres Límite: Humans Idioma: En Revista: Microsurgery Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cuero Cabelludo / Arterias Temporales / Procedimientos de Cirugía Plástica / Colgajos Tisulares Libres Límite: Humans Idioma: En Revista: Microsurgery Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos