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
{"title":"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","authors":"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","doi":"10.1002/micr.70099","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Introduction</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>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 (<i>I</i><sup>2</sup> = 0.00%; <i>Q</i> statistic 17.50, <i>p</i> = 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%).</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>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.</p>\n </section>\n </div>","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":"45 5","pages":""},"PeriodicalIF":1.7000,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Outcomes of Parascapular Free Flap in Reconstructive Microsurgery: A Systematic Review and Meta-Analysis\",\"authors\":\"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\",\"doi\":\"10.1002/micr.70099\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Introduction</h3>\\n \\n <p>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.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>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.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>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 (<i>I</i><sup>2</sup> = 0.00%; <i>Q</i> statistic 17.50, <i>p</i> = 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%).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion</h3>\\n \\n <p>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.</p>\\n </section>\\n </div>\",\"PeriodicalId\":18600,\"journal\":{\"name\":\"Microsurgery\",\"volume\":\"45 5\",\"pages\":\"\"},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2025-07-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Microsurgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/micr.70099\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Microsurgery","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/micr.70099","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"SURGERY","Score":null,"Total":0}
Outcomes of Parascapular Free Flap in Reconstructive Microsurgery: A Systematic Review and Meta-Analysis
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.
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.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
