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Free Flap Failure and Contracture Recurrence in Delayed Burn Reconstruction: A Systematic Review and Meta-analysis
Hilary Y Liu, BS; Mario Alessandri Bonetti, MD; Julia A Kasmirski, BS; Guy M Stofman, MD; Francesco M Egro, MD, MSc, MRCS
Department of Plastic Surgery, University of Pittsburgh Medical Center
2024-01-10
Presenter: Hilary Y Liu
Affidavit:
I agree with the above statement.
Director Name: Vu T Nguyen
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: General Reconstruction
Background
The success rate of free tissue transfer in delayed burn reconstruction varies in literature, and a comprehensive review on free flap outcomes in delayed burn reconstruction is currently lacking. This study aims to evaluate the available evidence on the failure and contracture recurrence rates in free flap delayed burn reconstruction.
Methods
A systematic review and meta-analysis was conducted. It was reported according to PRISMA guidelines and the protocol registered on PROSPERO (CRD42023404478). PubMed, Embase, Web of Science, and Cochrane Library databases were queried. The results were limited to English-language literature with extractable data on the free flap failure rate in delayed burn reconstruction only.
Results
Of the 1262 retrieved articles, 40 qualified for inclusion, reporting on 1026 free flaps performed in 928 patients (50.3% male, 49.7% female). The mean age was 29.25 years [95% CI: 24.63, 33.88]. Delayed burn reconstruction were performed at an average of 94.68 months [95% CI: -9.34, 198.70] after initial injury, with a follow-up period of 23.02 months [95% CI: 4.46, 41.58]. The flap loss rate was 3.80% [95% CI: 2.79, 5.16] for total flap loss (TFL) and 5.95% [95% CI: 4.65, 7.57] for partial flap loss (PFL). Contracture recurrence rate was 0.62% [95% CI: 0.20, 1.90].
Conclusion
This systematic review provides a comprehensive evaluation of the free flap outcomes in delayed burn reconstruction. The flap loss rate was relatively low, suggesting that free flaps are a safe and effective option for delayed burn reconstruction.
