Free flaps for reconstruction of soft tissue defects in lower extremity

• Verfasst von: Xiong, Lingyun [VerfasserIn]
• Verfasst von: Kremer, Thomas [VerfasserIn]
• Verfasst von: Hernekamp, Jochen-Frederick [VerfasserIn]
• Verfasst von: Harhaus-Wähner, Leila [VerfasserIn]
• Verfasst von: Kneser, Ulrich [VerfasserIn]
• Verfasst von: Hirche, Christoph [VerfasserIn]
• Titel: Free flaps for reconstruction of soft tissue defects in lower extremity
• Titelzusatz: A meta-analysis on microsurgical outcome and safety
• Verf.angabe: Lingyun Xiong, Emre Gazyakan, Thomas Kremer, Frederick J. Hernekamp, Leila Harhaus, Michel Saint-Cyr, Ulrich Kneser, and Christoph Hirche
• E-Jahr: 2016
• Jahr: 05 January 2016
• Umfang: 14 S.
• Teil: volume:36
• Teil: year:2016
• Teil: number:6
• Teil: pages:511-524
• Teil: extent:14
• Fussnoten: Gesehen am 28.09.2021
• Titel Quelle: Enthalten in: Microsurgery
• Ort Quelle: New York, NY [u.a.] : Wiley-Liss, 1979
• Jahr Quelle: 2016
• Band/Heft Quelle: 36(2016), 6, Seite 511-524
• ISSN Quelle: 1098-2752
• DOI: doi:10.1002/micr.30020
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 177195440X

Abstract

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.