Renita Wilson, Taylor Cave, Payam Entezami, Erin Ware, Brent A Chang
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Main analysis endpoints were flap failure rate, donor site morbidity, and complication rate.</p><p><strong>Results: </strong>Nine articles and 206 total PAP flaps were included. The rate of flap-related and medical complications was 33%, with only 2 (0.97%) instances of complete flap failure. Other complications included partial flap failure (10, 4.86%) and donor site wound complications (12, 5.83%). A total of 16 flaps (7.77%) required subsequent revision in the operating room. Average MINORS score of the studies suggested a moderate to high risk of bias.</p><p><strong>Conclusion: </strong>Based on limited quality evidence, this review suggests that the PAP flap is a safe and feasible tool for head and neck reconstruction, with comparable complication and success rates as other free flaps. Further large-scale studies are warranted.</p>","PeriodicalId":19697,"journal":{"name":"OTO Open","volume":"8 4","pages":"e70028"},"PeriodicalIF":1.8000,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11498058/pdf/","citationCount":"0","resultStr":"{\"title\":\"Systematic Review of the Profunda Artery Perforator Free Flap for Head and Neck Reconstruction.\",\"authors\":\"Renita Wilson, Taylor Cave, Payam Entezami, Erin Ware, Brent A Chang\",\"doi\":\"10.1002/oto2.70028\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>The profunda artery perforator (PAP) flap has gained popularity in head and neck reconstruction with a favorable donor site providing a relatively hidden scar and the ability to harvest a large amount of pliable tissue with consistent vascular anatomy. The primary aim of this study is to evaluate the safety and efficacy of this PAP flap in head and neck reconstruction.</p><p><strong>Data sources: </strong>PUBMED, EMBASE, Web of Science, Google Scholar (January 1948-February 2022).</p><p><strong>Review methods: </strong>A systematic review of the English language literature was conducted for studies with at least 3 patients 18 years or older undergoing head and neck reconstruction utilizing the PAP. Study quality and risk of bias were evaluated using the MINORS scoring system. Main analysis endpoints were flap failure rate, donor site morbidity, and complication rate.</p><p><strong>Results: </strong>Nine articles and 206 total PAP flaps were included. The rate of flap-related and medical complications was 33%, with only 2 (0.97%) instances of complete flap failure. Other complications included partial flap failure (10, 4.86%) and donor site wound complications (12, 5.83%). A total of 16 flaps (7.77%) required subsequent revision in the operating room. Average MINORS score of the studies suggested a moderate to high risk of bias.</p><p><strong>Conclusion: </strong>Based on limited quality evidence, this review suggests that the PAP flap is a safe and feasible tool for head and neck reconstruction, with comparable complication and success rates as other free flaps. 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引用次数: 0
摘要
目的:深动脉穿孔器(PAP)皮瓣在头颈部重建中越来越受欢迎,因为它具有良好的供体部位,疤痕相对隐蔽,而且能够获取大量柔韧的组织,血管解剖结构一致。本研究的主要目的是评估 PAP 皮瓣在头颈部重建中的安全性和有效性:数据来源:PUBMED、EMBASE、Web of Science、Google Scholar(1948 年 1 月至 2022 年 2 月):综述方法:对至少有 3 名 18 岁或以上患者接受头颈部重建术并使用 PAP 的英文文献进行了系统性综述。研究质量和偏倚风险采用 MINORS 评分系统进行评估。主要分析终点为皮瓣失败率、供体部位发病率和并发症发生率:结果:共纳入了 9 篇文章和 206 个 PAP 皮瓣。皮瓣相关并发症和医疗并发症的发生率为33%,只有2例(0.97%)皮瓣完全失败。其他并发症包括皮瓣部分失败(10 例,4.86%)和供体部位伤口并发症(12 例,5.83%)。共有 16 个皮瓣(7.77%)需要在手术室进行后续翻修。研究的平均MINORS评分显示存在中度至高度偏倚风险:基于质量有限的证据,本综述认为PAP皮瓣是一种安全可行的头颈部重建工具,其并发症发生率和成功率与其他游离皮瓣相当。有必要进一步开展大规模研究。
Systematic Review of the Profunda Artery Perforator Free Flap for Head and Neck Reconstruction.
Objective: The profunda artery perforator (PAP) flap has gained popularity in head and neck reconstruction with a favorable donor site providing a relatively hidden scar and the ability to harvest a large amount of pliable tissue with consistent vascular anatomy. The primary aim of this study is to evaluate the safety and efficacy of this PAP flap in head and neck reconstruction.
Data sources: PUBMED, EMBASE, Web of Science, Google Scholar (January 1948-February 2022).
Review methods: A systematic review of the English language literature was conducted for studies with at least 3 patients 18 years or older undergoing head and neck reconstruction utilizing the PAP. Study quality and risk of bias were evaluated using the MINORS scoring system. Main analysis endpoints were flap failure rate, donor site morbidity, and complication rate.
Results: Nine articles and 206 total PAP flaps were included. The rate of flap-related and medical complications was 33%, with only 2 (0.97%) instances of complete flap failure. Other complications included partial flap failure (10, 4.86%) and donor site wound complications (12, 5.83%). A total of 16 flaps (7.77%) required subsequent revision in the operating room. Average MINORS score of the studies suggested a moderate to high risk of bias.
Conclusion: Based on limited quality evidence, this review suggests that the PAP flap is a safe and feasible tool for head and neck reconstruction, with comparable complication and success rates as other free flaps. Further large-scale studies are warranted.