Journal of reconstructive microsurgery最新文献

{"title":"Dual-Innervated Gracilis Free Functional Muscle Transfers in Facial Palsy Patients: Comparing Long-Term Outcomes between One- versus Two-Stage Procedures.","authors":"Y Edward Wen, Roshni L Thachil, Adolfo Zamaro Madrazo, Cristina V Sanchez, Joan S Reisch, Shai M Rozen","doi":"10.1055/a-2245-9795","DOIUrl":"10.1055/a-2245-9795","url":null,"abstract":"<p><strong>Background: </strong> In facial reanimation, dual-innervated gracilis free functional muscle transfers (FFMTs) may have amalgamated increases in tone, excursion, synchroneity, and potentially spontaneity when compared with single innervation. The ideal staging of dual-innervated gracilis FFMTs has not been investigated. We aim to compare objective long-term outcomes following one- and two-stage dual-innervated gracilis FFMTs.</p><p><strong>Methods: </strong> Included were adult patients with facial paralysis who underwent either one- (one-stage group) or two-stage (two-stage group) dual-innervated gracilis FFMT with ≥1 year of postoperative follow-up. Facial measurements were obtained from standardized photographs of patients in repose, closed-mouth smile, and open-mouth smile taken preoperatively, 1 year postoperatively, and 3 years postoperatively. Symmetry was calculated from the absolute difference between the paralyzed and healthy hemiface; a lower value indicates greater symmetry.</p><p><strong>Results: </strong> Of 553 facial paralysis patients, 14 were included. Five and nine patients were in the one- and two-stage groups, with mean follow-up time, respectively, being 2.5 and 2.6 years. Within-group analysis of both groups, most paralyzed-side and symmetry measurements significantly improved over time with maintained significance at 3 years postoperatively in closed and open-mouth smile (all <i>p</i> ≤ 0.05). However, only the two-stage group had maintained significance in improvements at 3 years postoperatively in paralyzed-side and symmetry measurements in repose with commissure position (median change [interquartile range, IQR], 7.62 [6.00-10.56] mm), commissure angle (median change [IQR], 8.92 [6.18-13.69] degrees), commissure position symmetry (median change [IQR], -5.18 [-10.48 to -1.80] mm), commissure angle symmetry (median change [IQR], -9.78 [-11.73 to -7.32] degrees), and commissure height deviation (median change [IQR], -5.70 [-7.19 to -1.64] mm; all <i>p</i> ≤ 0.05). In the between-group analysis, all measurements were comparable in repose, closed-mouth smile, and open-mouth smile (all <i>p</i> > 0.05).</p><p><strong>Conclusion: </strong> Long-term outcomes demonstrate that both one- and two-stage dual-innervated gracilis FFMTs significantly improve excursion, but only two-stage reconstruction significantly improves resting tone.</p>","PeriodicalId":16949,"journal":{"name":"Journal of reconstructive microsurgery","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139472579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differential Diagnosis of \"Foot Drop\": Implications for Peripheral Nerve Surgery.","authors":"Mitchel Seruya","doi":"10.1055/a-2253-6360","DOIUrl":"10.1055/a-2253-6360","url":null,"abstract":"<p><strong>Background: </strong> At least 128,000 patients in the United States each year suffer from foot drop. This is a debilitating condition, marked by the inability to dorsiflex and/or evert the affected ankle. Such patients are rendered to a lifetime of relying on an ankle-foot orthosis (AFO) for walking and nighttime to prevent an equinovarus contracture.</p><p><strong>Methods: </strong> This narrative review explores the differential diagnosis of foot drop, with a particular focus on clinical presentation and recovery, whether spontaneously or through surgery.</p><p><strong>Results: </strong> Contrary to popular belief, foot drop can be caused by more than just insult to the common peroneal nerve at the fibular head (fibular tunnel). It is a common endpoint for a diverse spectrum of nerve injuries, which may explain its relatively high prevalence. From proximal to distal, these conditions include lumbar spine nerve root damage, sciatic nerve palsy at the sciatic notch, and common peroneal nerve injury at the fibular head. Each nerve condition is marked by a unique clinical presentation, frequency, likelihood for spontaneous recovery, and cadre of peripheral nerve techniques.</p><p><strong>Conclusion: </strong> The ideal surgical technique for treating foot drop, other than neurolysis for compression, remains elusive as traditional peripheral nerve procedures have been marred by a wide spectrum of functional results. Based on a careful understanding of why past techniques have achieved limited success, we can formulate a working set of principles to help guide surgical innovation moving forward, such as fascicular nerve transfer.</p>","PeriodicalId":16949,"journal":{"name":"Journal of reconstructive microsurgery","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139545071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying Functional Lymph Nodes in Lower Extremity Lymphedema Patients: The Role of High-frequency Ultrasound.","authors":"Feras Alshomer, Hyung Hwa Jeong, Changsik John Pak, Hyunsuk Peter Suh, Joon Pio Hong","doi":"10.1055/a-2238-7985","DOIUrl":"10.1055/a-2238-7985","url":null,"abstract":"<p><strong>Background: </strong> Lymph nodes may play a potential role in lymphedema surgery. Radiologic evaluation of nodes may reveal the status of pathologic conditions but with limited accuracy. This study is the first to evaluate the efficacy of ultrasound in detecting functioning nodes in lymphedema patients and presents a criterion for determining the functionality of the lymph nodes.</p><p><strong>Methods: </strong> This retrospective study reviews 30 lower extremity lymphedema cases which were candidates for lymph node to vein anastomosis. Lymphoscintigraphy and magnetic resonant lymphangiography (MRL) imaging were compared with ultrasound features which were correlated to intraoperative indocyanine green (ICG) nodal uptake as an indication of functionality.</p><p><strong>Results: </strong> Majority were International Society of Lymphology stage 2 late (50.0%) and stage 3 (26.7%). ICG positive uptake (functioning nodes) was noted in 22 (73.3%), while 8 patients (26.6%) had negative uptake (nonfunctioning). Ultrasound had significantly the highest specificity (100%) for identifying functional nodes followed by lymphoscintigraphy (55%) and MRL (36%; <i>p</i> = <i>0.002</i>, <i>p < 0.001</i>, respectively). This was associated with 100% positive predictive value compared against lymphoscintigraphy (44%) and MRL (36%; <i>p < 0.001 for both</i>). The identified ultrasound imaging criteria for functioning lymph node were oval lymph node shape (Solbiati Index), morphology, vascularity pattern, and vascularity quantification.</p><p><strong>Conclusion: </strong> The use of ultrasound in nodal evaluation was proven effective in different pathologic conditions and demonstrated the best prediction for functionality of the lymph node based on the new evaluation criteria.</p>","PeriodicalId":16949,"journal":{"name":"Journal of reconstructive microsurgery","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139098112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep Circumflex Iliac Artery-vascularized Iliac Bone Graft for Femoral Head Osteonecrosis: Computed Tomography Anatomical Study.","authors":"Jiale He, Yunxiang Lu, Yuxian Chen, You Peng, Qi Zhu, Zhiyong Li","doi":"10.1055/a-2238-7798","DOIUrl":"10.1055/a-2238-7798","url":null,"abstract":"<p><strong>Background: </strong> Deep circumflex iliac artery (DCIA)-vascularized iliac graft transposition is a method for treating femoral head osteonecrosis but with inconsistent efficacy. We aim to improve the method of this surgery by recommending the optimal location of the iliac pedicle to satisfy the vascular length for transposition and the blood supply of the vascularized iliac graft.</p><p><strong>Methods: </strong> The DCIA and its surrounding tissues were assessed on computed tomography angiography images for 100 sides (left and right) of 50 patients. The length of the vascular pedicle required for transposition and the length of the pedicle at different iliac spine positions were compared. The diameter and cross-sectional area of the DCIA and the distance between the DCIA and iliac spine were measured at different points to assess blood supply. We also compared differences in sex and left-right position.</p><p><strong>Results: </strong> The diameter and cross-sectional area of the DCIA gradually decreased after crossing the anterior superior iliac spine (ASIS), and it approached the iliac bone. However, when the DCIA was 4 cm behind the ASIS (54 sides, 54%), it coursed posteriorly and superiorly away from the iliac spine. The vascular length of the pedicle was insufficient to transpose the vascularized iliac graft to the desired position when it was within 1 cm of the ASIS. The vascular length requirement was satisfied, and the blood supply was sufficient when the pedicle was positioned at 2 or 3 cm.</p><p><strong>Conclusion: </strong> To obtain a satisfactory pedicle length and sufficient blood supply, the DCIA pedicle of the vascularized iliac graft should be placed 2 to 3 cm behind the ASIS. The dissection of DCIA has slight differences in sex and left-right position due to anatomical differences.</p>","PeriodicalId":16949,"journal":{"name":"Journal of reconstructive microsurgery","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11309803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139098108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Innovative Clinical Scenario Simulator for Step-by-Step Microsurgical Training.","authors":"Lei Cui, Yan Han, Xin Liu, Bao L Jiao, Hong G Su, Mi Chai, Miao Chen, Jun Shu, Wen W Pu, Le R He, Yu D Han","doi":"10.1055/a-2240-1305","DOIUrl":"10.1055/a-2240-1305","url":null,"abstract":"<p><strong>Background: </strong> Microsurgical training should be implemented with consideration of operative difficulties that occur in actual clinical situations. We evaluated the effectiveness of a novel clinical scenario simulator for step-by-step microsurgical training that progressed from conventional training to escalated training with additional obstacles.</p><p><strong>Methods: </strong> A training device was designed according to multiple and intricate clinical microsurgery scenarios. Twenty surgical residents with no experience in microsurgery were randomly assigned to either the control group (conventional training curricula, <i>n</i> = 10) or the experimental group (step-by-step training courses, <i>n</i> = 10). After 4 weeks of laboratory practice, the participants were scheduled to perform their first microvascular anastomoses on patients in an operating room. The Global Rating Scale (GRS) scores and operative duration were used to compare microsurgical skills between the two groups.</p><p><strong>Results: </strong> There were no significant differences in the participants' baseline characteristics before microsurgical training between the groups with respect to age, sex, postgraduate year, surgical specialty, or mean GRS score (<i>p</i> < 0.05). There were also no significant differences in recipient sites between the two groups (<i>p</i> = 0.735). After training, the GRS scores in both groups were significantly improved (<i>p</i> = 0.000). However, in the actual microsurgical situations, the GRS scores were significantly higher in the experimental than control group (<i>p</i> < 0.05). There was no significant difference in the operative duration between the two groups (<i>p</i> < 0.13).</p><p><strong>Conclusion: </strong> Compared with a traditional training program, this step-by-step microsurgical curriculum based on our clinical scenario simulator results in significant improvement in acquisition of microsurgical skills.</p>","PeriodicalId":16949,"journal":{"name":"Journal of reconstructive microsurgery","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139403385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"DIEP Donor Site Satisfaction between Patients with and without History of Pregnancy.","authors":"David Chon-Fok Cheong, Allen Wei-Jiat Wong, Shu-Wei Kao, Shu-Ying Chang, Jung-Ju Huang","doi":"10.1055/a-2238-8399","DOIUrl":"10.1055/a-2238-8399","url":null,"abstract":"<p><strong>Background: </strong> With the success of free autologous breast reconstruction, the abdominal donor site is now an important consideration, especially in patients of childbearing age. In our institution, there are increasing patients who have successfully undergone the deep inferior epigastric artery perforator (DIEP) flap despite previous pregnancy. This study aims to answer questions on the effect of the donor site on pregnancy and vice versa.</p><p><strong>Methods: </strong> A retrospective cohort study was conducted to identify breast cancer patients who received a free DIEP flap for breast reconstruction from January 2018 to August 2020. Patients were allocated to two groups according to whether they had prior pregnancies with successful deliveries. Demographics, flap-related parameters, surgical outcomes on breast and abdomen, and patient-reported outcome (Breast-Q questionnaire) were analyzed. Patients were excluded if follow-up time was less than 1 year, or if there was incomplete medical records or Breast-Q replies.</p><p><strong>Results: </strong> Ninety-nine of 116 patients had had successful pregnancies with delivery, 17 of them remained nulliparous. No statistically significant differences existed between groups regarding demographic data, flap-related parameters, surgical outcomes on breast and abdomen. Nulliparous patients exhibited significantly lower score in physical well-being in the abdomen domain compared with delivery-experienced patients (62.1 vs. 73.4, <i>p</i> = 0.025). Significantly, nulliparous patients felt more tightness and pulling of the abdominal wall than the delivery-experienced patients (2.9 vs. 3.7; <i>p</i> = 0.05 and 3.5 vs. 4.0; <i>p</i> = 0.04).</p><p><strong>Conclusion: </strong> Free DIEP flap can be transferred safely in nulliparous patients despite a slight increase in abdominal tightness and abdominal pulling. Precise flap design and surgical approaches may help to minimize the abdominal discomfort especially on young, normal body mass index, and nonchildbearing patients.</p>","PeriodicalId":16949,"journal":{"name":"Journal of reconstructive microsurgery","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139098109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhanced Free Flap Monitoring through Negative Pressure Wound Therapy Devices.","authors":"Michael P Grant, Gregory A Lamaris","doi":"10.1055/a-2238-7706","DOIUrl":"10.1055/a-2238-7706","url":null,"abstract":"","PeriodicalId":16949,"journal":{"name":"Journal of reconstructive microsurgery","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139098111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"THE GODINA PRINCIPLE IN THE 21ST CENTURY: FREE FLAP TIMING AFTER ISOLATED LOWER EXTREMITY TRAUMA IN A RETROSPECTIVE NATIONAL COHORT.","authors":"Theodore Edward Habarth-Morales, Harrison D Davis, Robyn Broach, Joseph M Serletti, Saïd Azoury, L Scott Levin, Stephen J Kovach, Irfan A Rhemtulla","doi":"10.1055/a-2404-7634","DOIUrl":"https://doi.org/10.1055/a-2404-7634","url":null,"abstract":"<p><strong>Background: </strong>The timing of free flap reconstruction after lower extremity trauma has been a controversial debate since Marko Godina's original 72 hour recommendation. Recent advances in microsurgery warrant an evaluation of the optimal time to reconstruction.</p><p><strong>Methods: </strong>The Nationwide Readmission Database (2014-2019) was used to identify patients undergoing free flap reconstruction after lower extremity trauma. Risk-adjusted statistical methods were used to identify optimal time where risk of infectious and microsurgical complications increase and to quantify the risk associated with time delays.</p><p><strong>Results: </strong>One-thousand and thirty patients undergoing reconstruction were identified. The mean time to flap coverage was 24.3 days. Thirty-three percent were performed within 72 hours, 24% from 72 hours-10 days, 18% from 10-30 days, and 24% after 30 days. Flaps performed after 10 days were associated with increased risk of surgical site infection, osteomyelitis, and other wound complications, compared to those performed within 72 hours. There was no increased risk in the period of 72 hours to 10 days. Revision amputation and microsurgical complications were not increased after 10 days. The predicted optimal cutoff was 9.5 days for microsurgical complications and 14.5 days for infectious complications.</p><p><strong>Conclusions: </strong>Advances in microsurgery may be responsible for extending the time in which definitive soft tissue coverage is required for wounds resulting from lower extremity trauma. Although it appears the original 72-hour time window can be safely extended, efforts should be made to refer patients to specialty limb salvage centers in a timely fashion.</p>","PeriodicalId":16949,"journal":{"name":"Journal of reconstructive microsurgery","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142080681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Post-operative Pain Course Following Primary and Secondary Targeted Muscle Reinnervation - a Temporal Description of Pain Outcomes.","authors":"Floris Raasveld, Yannick Albert J Hoftiezer, Barbara Gomez-Eslava, Justin McCarty, Ian L Valerio, Marilyn Heng, Kyle R Eberlin","doi":"10.1055/a-2404-7732","DOIUrl":"https://doi.org/10.1055/a-2404-7732","url":null,"abstract":"<p><strong>Introduction: </strong>Targeted muscle reinnervation (TMR) is an effective surgical treatment of neuropathic pain for amputees. However, limited data exists regarding the early post-operative pain course for patients who undergo either Primary (<14 days since amputation) or Secondary (≥14 days) TMR. This study aims to outline the post-operative pain course for Primary and Secondary TMR during the first six post-operative months, to aid in patient education and expectation management.</p><p><strong>Methods: </strong>Patients were eligible if they underwent TMR surgery between 2017 and 2023. Prospectively collected patient-reported outcome measures of pain scores, Pain Interference, and Pain Intensity were analyzed. Multilevel mixed-effect models were utilized to visualize and compare pain courses between Primary and Secondary TMR patients.</p><p><strong>Results: </strong>A total of 203 amputees were included, with 40.9% being Primary and 59.1% being Secondary TMR patients. Primary TMR patients reported significantly lower pain scores over the full 6-month post-operative trajectory (p<0.001) compared to Secondary TMR patients, with a difference of Δ-1.0 at day of TMR (Primary=4.5, Secondary=5.5), and a difference of Δ-1.4 at the 6-month mark (Primary=3.6, Secondary=5.0). Primary TMR patients also reported significantly lower Pain Interference (p<0.001) and Pain Intensity scores (p<0.001) over the complete trajectory of their care.</p><p><strong>Conclusion: </strong>Primary TMR patients report lower pain during the first six months post-operatively compared to secondary TMR patients. This may reflect how pre-existing neuropathic pain is more challenging to mitigate through peripheral nerve surgery. The current trends may assist in both understanding the post-operative pain course and in managing patient expectations following TMR.</p>","PeriodicalId":16949,"journal":{"name":"Journal of reconstructive microsurgery","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142080677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comparison of Postoperative Outcomes Based on Muscle versus Fasciocutaneous Flaps in Scalp Reconstruction: A Systematic Review and Meta-Analysis.","authors":"Eloise W Stanton, Asli Pekcan, Idean Roohani, Deborah Choe, Joseph Nicholas Carey, David Daar","doi":"10.1055/a-2404-2539","DOIUrl":"https://doi.org/10.1055/a-2404-2539","url":null,"abstract":"<p><strong>Introduction: </strong>Scalp reconstruction in plastic and reconstructive surgery often necessitates the transfer of soft tissue flaps to restore form and function. The critical decision lies in choosing between muscle-containing (MC) and fasciocutaneous (FC) flaps for scalp reconstruction, and while both variants have their merits, flap composition remains a subject of ongoing debate. This scientific discussion aims to explore this contentious issue through a comprehensive meta-analysis, shedding light on the rationale behind the choice of these flaps and the potential impact on clinical outcomes.</p><p><strong>Methods: </strong>A comprehensive systematic review was conducted following PRISMA-P guidelines, encompassing six prominent databases up to the year 2023. Data were collected from studies assessing outcomes of MC and FC flaps for scalp reconstruction. Quality evaluation was performed using ASPS criteria and the ROBINS-I tool. Statistical analysis included descriptive statistics, meta-analysis, sensitivity analysis, and assessment of bias using STATA software.</p><p><strong>Results: </strong>The meta-analysis included 28 non-randomized studies, totaling 594 flaps (380 MC, 214 FC). MC flaps were significantly larger than FC flaps. There were no significant differences in flap loss, flap necrosis, or wound dehiscence between the two flap types. However, the incidence of venous congestion was significantly higher in FC flaps. Sensitivity analysis confirmed the robustness of results, and publication bias assessment showed no significant evidence of bias.</p><p><strong>Conclusions: </strong>While both MC and FC flaps offer viable options for scalp reconstruction, the choice should be tailored to individual patient characteristics and defect size. FC flaps may provide advantages such as shorter operative times and reduced morbidity, whereas MC flaps could be preferred for addressing larger defects. Future research should focus on prospective studies and strategies to mitigate venous congestion in FC flaps, enhancing their safety and efficacy in scalp reconstruction.</p>","PeriodicalId":16949,"journal":{"name":"Journal of reconstructive microsurgery","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142080673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}