Study title

Survival of microvascular free flaps in mandibular reconstruction: A systematic review and meta-analysis

journal

Microsurgery

study year

2015

QUESTION

Among patients undergoing microvascular free tissue transfer to the mandible, do any of the most commonly used free flaps, when compared to each other, have a lower recipient site survival rate?

Study DESIGN

Meta-analysis (n=17)

STUDY GROUPS

DCIA vs fibula (n=10)/radial forearm (n=5)/scapula (n=2)/all other flaps (n=13)

Fibular vs scapula (n=6)/radial forearm (n=8)/all other flaps (n=15)

Radial forearm vs all other flaps (n=10)

Population

Patients undergoing free flaps for mandibular reconstruction (n=1,221)

Inclusion criteria

Published in English

Reported the use of free flaps for mandibular reconstruction

Human subjects

Reported descriptive statistics for ³2 free flap harvest sites

Reported in adults

Exclusion criteria

Reported in children (<18 y/o)

Sites other than the mandible

Cadavers

Non-human subjects

Follow-up

Variable (9-52 months)

Primary endpoint(s)

Recipient site survival at follow-up: 94.8% overall. DCIA had 7x increased failure rate vs RFFF (Peto OR = 7.4; CI – 1.38, 39.75, p=0.02). No difference in survivial comparing other free flaps.

Secondary endpoint(s)

None

Weblink

https://onlinelibrary.wiley.com/doi/abs/10.1002/micr.22471

Brief summary

Free flap reconstruction of mandible has high success rate. No difference in recipient site survival comparing various free flaps for mandibular reconstruction, except increased survival of RFFF vs DCIA

Authors

Markiewicz et al

Division of Head Neck Surgery, Department of Oral and Maxillofacial Surgery, Division of Surgical Oncology, University of Florida College of Medicine, Jacksonville, USA