Outcomes of Parascapular Free Flap in Reconstructive Microsurgery: A Systematic Review and Meta-Analysis

IF 1.7 3区医学 Q3 SURGERY

Microsurgery Pub Date : 2025-07-25 DOI:10.1002/micr.70099

Agustin N. Posso, Audrey Mustoe, Maria J. Escobar-Domingo, Charlotte Thomas, Jade E. Smith, Jose Foppiani, Dorien I. Schonebaum, Noelle Garbaccio, Samuel J. Lin, Bernard T. Lee

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引用次数: 0

Abstract

Introduction

The parascapular free flap (PFF), primarily harvested as a fasciocutaneous flap, is perfused by the parascapular branch of the circumflex scapular artery. Its anatomy enables modification and combination with other flaps. However, its use in reconstructive microsurgery has not been comprehensively characterized. This systematic review and meta-analysis aim to assess the key features and outcomes of the PFF.

Methods

The study protocol followed the PRISMA guidelines. Multiple online databases were used to identify articles published through 2024. Studies including patients who underwent PFF procedures were eligible. A two-stage screening process was conducted for study selection. Data extraction focused on the primary outcome (failure rate), secondary outcomes (other complications), and additional information. An analysis of pooled data was performed to evaluate rates of complications.

Results

Eighty-four articles were included in this review. A total of 647 patients and 664 PFFs were identified; among these, 57.38% were harvested solely as PFFs, while 42.62% involved combinations with other free flaps. The predominant recipient site was the head and neck, accounting for 72.52% of cases. The leading indications were malignancy (28.64%), post-burn scarring (17.35%), and trauma (13.26%). Meta-analysis of the primary outcome revealed no heterogeneity across the studies (I² = 0.00%; Q statistic 17.50, p = 0.56), with a pooled failure rate of 0.99% (95% CI: 0%–2.63%). Other complication rates included partial necrosis (2.09%, 95% CI: 0%–5.45%), hematoma (5.18%, 95% CI: 1.34%–10.63%), wound dehiscence (5.98%, 95% CI: 0.38%–15.47%), infection (0.86%, 95% CI: 0.00%–3.97%), and venous thrombosis (1.57%, 95% CI: 0.00%–4.95%).

Conclusion

The PFF is a versatile and reliable option in reconstructive microsurgery, offering low failure rates and minimal complications. Its applicability across various anatomical regions and indications makes it an invaluable option for microsurgeons.

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肩胛旁游离皮瓣在显微外科重建中的效果：系统回顾和荟萃分析

肩胛旁自由皮瓣（PFF）主要作为筋膜皮瓣，由旋肩胛动脉的肩胛旁分支灌注。它的解剖结构可以修饰和与其他皮瓣结合。然而，其在重建显微外科中的应用尚未得到全面的描述。本系统综述和荟萃分析旨在评估PFF的主要特征和结果。方法研究方案遵循PRISMA指南。多个在线数据库用于识别到2024年出版的文章。包括接受PFF手术的患者的研究是合格的。通过两阶段筛选过程进行研究选择。数据提取侧重于主要结果（失败率）、次要结果（其他并发症）和其他信息。对合并数据进行分析以评估并发症的发生率。结果共纳入84篇文献。共发现647例患者和664例pff；其中，单独作为游离皮瓣收获的占57.38%，与其他游离皮瓣组合收获的占42.62%。主要受累部位为头颈部，占72.52%。主要指征为恶性肿瘤（28.64%）、烧伤后瘢痕（17.35%）和创伤（13.26%）。对主要结局的荟萃分析显示，各研究间无异质性(I2 = 0.00%；Q统计量为17.50,p = 0.56)，合并失败率为0.99% （95% CI: 0% ~ 2.63%）。其他并发症发生率包括部分坏死（2.09%,95% CI: 0% ~ 5.45%）、血肿（5.18%,95% CI: 1.34% ~ 10.63%）、创面裂开（5.98%,95% CI: 0.38% ~ 15.47%）、感染（0.86%,95% CI: 0.00% ~ 3.97%）、静脉血栓形成（1.57%,95% CI: 0.00% ~ 4.95%）。结论PFF在显微重建手术中是一种功能齐全、可靠的选择，失败率低，并发症少。它适用于各种解剖区域和适应症，使其成为显微外科医生的宝贵选择。

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.