Survival and infection rates of microvascular free flaps in pediatric mandibular reconstruction: A systematic review and meta-analysis

IF 1.5 3区医学 Q3 SURGERY

Microsurgery Pub Date : 2024-06-03 DOI:10.1002/micr.31200

Ryan S. Huang MSc, Ali Benour, Karen W. Y. Wong Riff MD, PhD, FRCSC

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引用次数: 0

Abstract

Background

Vascularized free tissue transfer has been established as an effective method in the reconstruction of mandibular defects. However, a limited understanding of its efficacy in pediatric patients persists due to its infrequent presentation. The aim of this study is to systematically consolidate the survival and infection rates of free flaps in pediatric mandibular reconstruction.

Methods

A systematic literature search was conducted on Ovid Medline, Embase, and Cochrane Library for studies published up to January 2024. We included peer-reviewed studies reporting on survival and infection outcomes associated with free flap mandibular reconstruction in pediatric patients (<18 years). We performed a random-effects meta-analysis with the inverse-variance weighted approach to estimate survival and infection rates. Heterogeneity was assessed by I², and publication bias was examined using Egger's test.

Results

A total of 26 studies, reporting on 463 free flaps and 439 pediatric patients with a mean age of 10.7 years, were included in our study. Most free flaps originated from the fibula (n = 392/463, 84.7%) and benign tumors were the most common cause for mandibular reconstruction (n = 179/463, 38.7%). The pooled estimate for survival of flaps was 96% (95% CI: 93–97, I² = 0%), and recipient-site infections were estimated to occur in 9% (95% CI: 6–13, I² = 0%) of cases. The most common reported complications within the study timeframe were early malocclusion (n = 28/123, 21.4%) and bite abnormalities (18/131, 13.7%).

Conclusion

Free tissue transfer for mandibular reconstruction in pediatric patients is effective and safe. Further research is required to explore functionality following mandibular reconstruction in diverse pediatric populations.

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小儿下颌骨重建中微血管游离皮瓣的存活率和感染率：系统回顾和荟萃分析。

背景：血管化游离组织移植已被确定为重建下颌骨缺损的有效方法。然而，由于这种方法在儿童患者中并不常见，因此对其疗效的了解仍然有限。本研究的目的是系统整合游离皮瓣在小儿下颌骨重建中的存活率和感染率：在 Ovid Medline、Embase 和 Cochrane Library 上对截至 2024 年 1 月发表的研究进行了系统性文献检索。我们纳入了报告儿科患者下颌骨游离瓣重建相关存活率和感染结果的同行评议研究（2），并使用Egger检验检查了发表偏倚：我们的研究共纳入了 26 项研究，报告了 463 个游离皮瓣和 439 名平均年龄为 10.7 岁的儿科患者。大多数游离皮瓣来自腓骨（n = 392/463，84.7%），良性肿瘤是下颌骨重建最常见的原因（n = 179/463，38.7%）。皮瓣存活率的汇总估计值为96%（95% CI：93-97，I2 = 0%），受体部位感染估计发生率为9%（95% CI：6-13，I2 = 0%）。研究期间最常见的并发症是早期咬合不正（28/123，21.4%）和咬合异常（18/131，13.7%）：结论：游离组织转移用于儿童患者的下颌骨重建是有效且安全的。结论：游离组织转移用于儿科患者的下颌骨重建是有效和安全的，需要进一步研究探讨不同儿科人群下颌骨重建后的功能。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Microsurgery 医学-外科

CiteScore

3.80

自引率

19.00%

发文量

128

审稿时长

4-8 weeks

期刊介绍： Microsurgery is an international and interdisciplinary publication of original contributions concerning surgery under microscopic magnification. Microsurgery publishes clinical studies, research papers, invited articles, relevant reviews, and other scholarly works from all related fields including orthopaedic surgery, otolaryngology, pediatric surgery, plastic surgery, urology, and vascular surgery.