前臂桡骨游离皮瓣最佳皮瓣结果的静脉选择:系统回顾和meta回归。

IF 2.2 3区 医学 Q1 OTORHINOLARYNGOLOGY
Christian Chong, Justin Lindsay, Lois Nguapa, Kevin G Wu, Timothy N Crawford, Mark Wax, Yadranko Ducic, Mohamedkazim Alwani, Sameep P Kadakia
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引用次数: 0

摘要

背景:桡骨前臂游离皮瓣是显微外科康复的主要重建方式。可靠的解剖结构,薄而柔韧的组织的可用性和长蒂为外科医生提供了很大的重建自由度,使该皮瓣对许多身体部位都有用。虽然动脉解剖是直接的,但皮瓣的静脉流出通常是通过一个利用浅静脉系统、深静脉系统和联合静脉系统的回路。这使得外科医生有多种静脉选择,但也在社区中产生了关于最佳血管选择的争论。这篇手稿试图检查在文献中发表的研究,以确定是否有统计学上显著的差异存在于静脉流出的选择,因为他们导致显微手术的成功。方法:系统回顾和meta回归分析了14项研究,共1182例前臂桡侧皮瓣。聘请了一位大学统计学家对结果进行详细分析。结果:结果显示,术中认为流出良好时,浅静脉引流系统、深静脉引流系统和联合静脉引流系统皮瓣效果无统计学差异。结论:静脉流出系统的选择对前臂桡侧皮瓣的修复效果没有影响。只要静脉流出有利,外科医生的偏好、技术技能和患者解剖结构应是决定静脉选择的指导因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Vein Selection for Optimal Flap Outcomes in the Radial Forearm Free Flap: A Systematic Review and Meta-Regression.

Background: Radial forearm free flaps represent a workhorse reconstructive modality in microsurgical rehabilitation. The reliable anatomy, availability of thin, pliable tissue, and a long pedicle afford the surgeon a significant latitude of reconstructive freedom, allowing this flap to be useful for a multitude of body sites. Although the arterial anatomy is straightforward, the venous outflow of the flap is generally through a circuit utilizing a superficial, deep, and united venous system. This has allowed surgeons a variety of venous options to utilize, but has also generated debate in the community regarding the optimal vessel choice. This manuscript seeks to examine published studies in the literature in an effort to determine if a statistically significant difference exists among venous outflow options as they lead to microsurgical success.

Methods: A systematic review and meta-regression were conducted examining 14 studies with a total of 1182 radial forearm flaps. A university-based statistician was recruited to perform a detailed analysis of the results.

Results: Results show that there is no statistically significant difference in flap outcomes among the superficial, deep, and united venous drainage systems when outflow is deemed to be favorable intraoperatively.

Conclusions: The choice of venous outflow system does not impact outcomes of the radial forearm flap. Surgeon preference, technical skill, and patient anatomy should be the guiding factors in determining vein choice so long as the venous outflow is favorable.

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来源期刊
CiteScore
7.00
自引率
6.90%
发文量
278
审稿时长
1.6 months
期刊介绍: Head & Neck is an international multidisciplinary publication of original contributions concerning the diagnosis and management of diseases of the head and neck. This area involves the overlapping interests and expertise of several surgical and medical specialties, including general surgery, neurosurgery, otolaryngology, plastic surgery, oral surgery, dermatology, ophthalmology, pathology, radiotherapy, medical oncology, and the corresponding basic sciences.
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