Cargando…

Free versus Pedicled Flaps for Lower Limb Reconstruction: A Meta-Analysis of Comparative Studies

Background: Free and pedicled flaps are both valuable surgical strategies for lower limb reconstruction. Evidence that compares both techniques is scarce. Our aim is to synthetise all the comparative studies by conducting a meta-analysis to identify post-operative outcomes. Method: A systematic revi...

Descripción completa

Detalles Bibliográficos
Autores principales: Scampa, Matteo, Mégevand, Vladimir, Suva, Domizio, Kalbermatten, Daniel F., Oranges, Carlo M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9267676/
https://www.ncbi.nlm.nih.gov/pubmed/35806957
http://dx.doi.org/10.3390/jcm11133672
_version_ 1784743790765932544
author Scampa, Matteo
Mégevand, Vladimir
Suva, Domizio
Kalbermatten, Daniel F.
Oranges, Carlo M.
author_facet Scampa, Matteo
Mégevand, Vladimir
Suva, Domizio
Kalbermatten, Daniel F.
Oranges, Carlo M.
author_sort Scampa, Matteo
collection PubMed
description Background: Free and pedicled flaps are both valuable surgical strategies for lower limb reconstruction. Evidence that compares both techniques is scarce. Our aim is to synthetise all the comparative studies by conducting a meta-analysis to identify post-operative outcomes. Method: A systematic review of pubmed, EMBASE, Cochrane library, and Web of Science was conducted, aiming at articles comparing the outcomes of free versus pedicled flaps in lower limb reconstruction. A pooled analysis with the Mantel and Haenszel methods and random effect analysis provided results as a risk ratio with a 95% confidence interval. Results: 10 retrospective studies were selected. While the flap necrosis rate did not differ significantly between techniques (RR 1.35, 95%CI 0.76–2.39, p = 0.31), the partial flap necrosis rate was significantly lower in free flaps (RR 0.45, 95%CI 0.22–0.91, p = 0.03). The overall complication rate (RR 0.83, 95%CI 0.64–1.07, p = 0.16) and revision surgery rate (RR 1.38, 95%CI 0.55–3.50, p = 0.49) did not differ significantly. No significant difference was found in the high aesthetic satisfaction rate (RR 1.76, 95%CI 0.57–5.41, p = 0.32) and post-operative infection rate (RR 0.85, 95%CI 0.55–1.33, p = 0.48). Conclusion: Despite important variability in the choice of flaps and outcomes reported among studies, free and pedicled flaps appear to be reliable surgical strategies for lower limb reconstruction with similar surgical outcomes.
format Online
Article
Text
id pubmed-9267676
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-92676762022-07-09 Free versus Pedicled Flaps for Lower Limb Reconstruction: A Meta-Analysis of Comparative Studies Scampa, Matteo Mégevand, Vladimir Suva, Domizio Kalbermatten, Daniel F. Oranges, Carlo M. J Clin Med Article Background: Free and pedicled flaps are both valuable surgical strategies for lower limb reconstruction. Evidence that compares both techniques is scarce. Our aim is to synthetise all the comparative studies by conducting a meta-analysis to identify post-operative outcomes. Method: A systematic review of pubmed, EMBASE, Cochrane library, and Web of Science was conducted, aiming at articles comparing the outcomes of free versus pedicled flaps in lower limb reconstruction. A pooled analysis with the Mantel and Haenszel methods and random effect analysis provided results as a risk ratio with a 95% confidence interval. Results: 10 retrospective studies were selected. While the flap necrosis rate did not differ significantly between techniques (RR 1.35, 95%CI 0.76–2.39, p = 0.31), the partial flap necrosis rate was significantly lower in free flaps (RR 0.45, 95%CI 0.22–0.91, p = 0.03). The overall complication rate (RR 0.83, 95%CI 0.64–1.07, p = 0.16) and revision surgery rate (RR 1.38, 95%CI 0.55–3.50, p = 0.49) did not differ significantly. No significant difference was found in the high aesthetic satisfaction rate (RR 1.76, 95%CI 0.57–5.41, p = 0.32) and post-operative infection rate (RR 0.85, 95%CI 0.55–1.33, p = 0.48). Conclusion: Despite important variability in the choice of flaps and outcomes reported among studies, free and pedicled flaps appear to be reliable surgical strategies for lower limb reconstruction with similar surgical outcomes. MDPI 2022-06-25 /pmc/articles/PMC9267676/ /pubmed/35806957 http://dx.doi.org/10.3390/jcm11133672 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Scampa, Matteo
Mégevand, Vladimir
Suva, Domizio
Kalbermatten, Daniel F.
Oranges, Carlo M.
Free versus Pedicled Flaps for Lower Limb Reconstruction: A Meta-Analysis of Comparative Studies
title Free versus Pedicled Flaps for Lower Limb Reconstruction: A Meta-Analysis of Comparative Studies
title_full Free versus Pedicled Flaps for Lower Limb Reconstruction: A Meta-Analysis of Comparative Studies
title_fullStr Free versus Pedicled Flaps for Lower Limb Reconstruction: A Meta-Analysis of Comparative Studies
title_full_unstemmed Free versus Pedicled Flaps for Lower Limb Reconstruction: A Meta-Analysis of Comparative Studies
title_short Free versus Pedicled Flaps for Lower Limb Reconstruction: A Meta-Analysis of Comparative Studies
title_sort free versus pedicled flaps for lower limb reconstruction: a meta-analysis of comparative studies
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9267676/
https://www.ncbi.nlm.nih.gov/pubmed/35806957
http://dx.doi.org/10.3390/jcm11133672
work_keys_str_mv AT scampamatteo freeversuspedicledflapsforlowerlimbreconstructionametaanalysisofcomparativestudies
AT megevandvladimir freeversuspedicledflapsforlowerlimbreconstructionametaanalysisofcomparativestudies
AT suvadomizio freeversuspedicledflapsforlowerlimbreconstructionametaanalysisofcomparativestudies
AT kalbermattendanielf freeversuspedicledflapsforlowerlimbreconstructionametaanalysisofcomparativestudies
AT orangescarlom freeversuspedicledflapsforlowerlimbreconstructionametaanalysisofcomparativestudies