scholarly journals The efficacy of the Cook-Swartz implantable doppler in the detection of free flap compromise: A systematic review and meta-analysis

2015 ◽  
Vol 23 ◽  
pp. S46
Author(s):  
R. Agha ◽  
B. Gundogan ◽  
A. Fowler ◽  
T. Bragg ◽  
D. Orgill
Keyword(s):  
Systematic Review ◽  
Free Flap ◽  
Meta Analysis

Enhanced recovery after surgery for head and neck free flap reconstruction: A systematic review and meta-analysis

Oral Oncology ◽  
2021 ◽  
Vol 113 ◽  
pp. 105117
Author(s):  
Kevin Chorath ◽  
Beatrice Go ◽  
Justin R. Shinn ◽  
Leila J. Mady ◽  
Seerat Poonia ◽  
...  
Keyword(s):  
Systematic Review ◽  
Head And Neck ◽  
Free Flap ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Meta Analysis ◽  
Flap Reconstruction ◽  
Free Flap Reconstruction

scholarly journals Naso- or Orbitocutaneous Fistulas after Free Flap Reconstruction of Orbital Exenteration Defects: Retrospective Study, Systematic Review, and Meta-Analysis

2017 ◽  
Vol 78 (04) ◽  
pp. 337-345 ◽  
Author(s):  
Kurren Gill ◽  
David Hsu ◽  
Gurston Nyquist ◽  
Howard Krein ◽  
Jurij Bilyk ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Free Flap ◽  
Meta Analysis ◽  
Fistula Formation ◽  
Wound Complications ◽  
Orbital Exenteration ◽  
Flap Reconstruction ◽  
Free Flap Reconstruction ◽  
Orbital Wall

Objective Naso- or orbitocutaneous fistula (NOF) is a challenging complication of orbital exenteration, and it often requires surgical repair. We sought to identify the incidence and risk factors for NOF after orbital exenteration. Study Design Retrospective chart review, systematic review, meta-analysis. Setting Tertiary care center. Participants Patients undergoing free flap reconstruction following orbital exenteration. Records were reviewed for clinicopathologic data, operative details, and outcomes. Main Outcome Measures Univariate analysis was used to assess risk factors for incidence of postoperative NOF. PubMed and Cochrane databases were searched for published reports on NOF after orbital exenteration. Rates of fistula and odds ratios for predictive factors were compared in a meta-analysis. Results Total 7 of 77 patients (9.1%) developed NOF; fistula formation was associated with ethmoid sinus involvement (p < 0.05) and minor wound break down (p < 0.05). On meta-analysis, pooled rates of fistula formation were 5.8% for free flap patients and 12.5% for patients receiving no reconstruction. Conclusion Immediate postoperative wound complications and medial orbital wall resection increased the risk for NOF. On review and meta-analysis, reconstruction of orbital exenteration defects decreased the risk for fistula formation, but published series did not demonstrate a significant decrease in risk with free flaps compared with other methods of reconstruction.

Intraoperative evaluation of perfusion in free flap surgery: A systematic review and meta-analysis

Microsurgery ◽  
2018 ◽  
Vol 38 (7) ◽  
pp. 804-818 ◽  
Author(s):  
Jan Maerten Smit ◽  
Vera L. Negenborn ◽  
Sanne M. Jansen ◽  
Mariëlle E. H. Jaspers ◽  
Ralph de Vries ◽  
...  
Keyword(s):  
Systematic Review ◽  
Free Flap ◽  
Meta Analysis ◽  
Flap Surgery ◽  
Intraoperative Evaluation ◽  
Free Flap Surgery

scholarly journals One Versus 2 Venous Anastomoses in Free Flap Surgery: A Systematic Review and Meta-Analysis

2017 ◽  
Vol 26 (2) ◽  
pp. 91-98
Author(s):  
Jennifer L. K. Matthews ◽  
Noor Alolabi ◽  
Forough Farrokhyar ◽  
Sophocles H. Voineskos
Keyword(s):  
Systematic Review ◽  
Free Flap ◽  
Meta Analysis ◽  
Venous Congestion ◽  
Flap Surgery ◽  
Flap Failure ◽  
Free Flap Surgery ◽  
Significant Difference ◽  
Reoperation Rates ◽  
Venous Flap

Background: The necessity of a second venous anastomosis in free flap surgery is controversial. The purpose of this systematic review is to determine whether venous flap failure and reoperation rates are lower when 2 venous anastomoses are performed. The secondary objective is to determine whether venous flap failure and reoperation rates are lower when the 2 veins are from 2 different drainage systems. Methods: A comprehensive search of the literature identified relevant studies. Investigators independently extracted data on rates of flap failure and reoperation secondary to venous congestion. A meta-analysis was performed; odds ratios (ORs) were pooled using a random-effects model and 95% confidence intervals (CIs). Results: Of 18 190 studies identified, 15 were included for analysis. The mean sample size was 287 patients (minimum = 102, maximum = 564). No statistically significant difference in venous flap failure was found when comparing 1 versus 2 venous anastomoses (OR: 1.35; 95% CI: 0.46-3.93). A significant decrease in reoperation rate due to venous congestion was shown (OR: 3.03; 95% CI: 1.64-5.58). The results favor using 2 veins from 2 different systems over veins from the same system (OR: 0.16; 95% CI: 0.02-1.27). Conclusions: There is low-quality evidence suggesting that the use of 2 venous anastomoses will lower the rate of reoperation due to venous congestion. There are insufficient data published to meaningfully compare outcomes of flaps with 2 venous anastomoses from different systems to flaps with anastomoses from the same system.

scholarly journals The Efficacy of the Cook–Swartz Implantable Doppler in the Detection of Free-Flap Compromise: A Systematic Review and Meta-Analysis

2016 ◽  
Vol 01 (02) ◽  
pp. 073-081 ◽  
Author(s):  
Riaz Agha ◽  
Alexander Fowler ◽  
Thomas Bragg ◽  
Dennis Orgill ◽  
Buket Gundogan
Keyword(s):  
Systematic Review ◽  
Free Flap ◽  
Meta Analysis

Perioperative Vasopressor Use in Free Flap Surgery: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 35 (07) ◽  
pp. 529-540 ◽  
Author(s):  
Cindy S.L. Goh ◽  
Marcus J.M. Ng ◽  
David H. Song ◽  
Adrian S.H. Ooi
Keyword(s):  
Systematic Review ◽  
Free Flap ◽  
Meta Analysis ◽  
Head And Neck Reconstruction ◽  
Complication Rates ◽  
Flap Surgery ◽  
Flap Failure ◽  
Free Flap Surgery ◽  
Vasopressor Use ◽  
The Impact

Background The use of vasopressors in free flap surgery has traditionally been avoided due to the presumed risk of pedicle vasospasm leading to flap failure. However, there is a lack of strong clinical evidence to suggest that their administration during microvascular surgery is absolutely contraindicated. The aim of this study is to clarify the impact of perioperative vasopressor use on free flap outcomes. Methods A systematic review was performed of all English-language articles that have compared free flap outcomes between patients who received vasopressors and those who did not. The outcome measures were total flap failure, pedicle thrombosis, and overall flap complications. Meta-analysis was performed using Mantel–Haenszel fixed-effects and DerSimonian and Laird random-effects models. Results From a total of 130 citations, 14 studies representing 8,653 cases were analyzed. Majority of these did not find any negative effects of vasopressor use irrespective of dose, timing of administration, and method of delivery. Meta-analysis demonstrated that vasopressors were associated with less total flap failure overall (odds ratio, [OR]: 0.71, p = 0.05) and less pedicle thrombosis in head and neck reconstruction specifically (OR: 0.58, p = 0.02). Flap complication rates were similar across all defect types (OR: 0.97, p = 0.81) but appeared to be increased in breast reconstruction (OR: 1.46, p = 0.01). Conclusion Perioperative vasopressor administration does not appear to be as detrimental to free flap survival as has been previously feared. Their role in optimizing hemodynamic stability may have a more beneficial effect on overall flap perfusion and in minimizing the complications of iatrogenic fluid overload.

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