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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...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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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 |
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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 |
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