Faculty of Medicine, Université de Montreal, Montreal, QC, Canada.
Division of Otolaryngology - Head & Neck Surgery service, Université de Montréal, Montreal, QC, Canada.
J Otolaryngol Head Neck Surg. 2019 Mar 14;48(1):13. doi: 10.1186/s40463-019-0334-y.
The present review focuses on comparative studies of reconstruction with free flaps (FF) versus pedicled flaps (PF) after oncologic resection.
A systematic review was developed in compliance with PRISMA guidelines and performed using the Pubmed, Medline, EMBASE, Amed and Biosis databases.
A total of 30 articles were included. FF are associated with a longer operative time, a higher cost and a higher incidence of postoperative revisions compared to PF. FF are associated with a longer stay at the intensive care unit than the supraclavicular artery island flap (SCAIF) and with a more extended hospital stay compared to the submental island flap (SMIF). FF are associated with fewer infections and necrosis compared to the pectoralis major myocutaneous flap (PMMF).
The comparison of both type of flaps is limited by the inherent design of the studies included. In sum, FF seem superior to the PMMF for several outcomes. SMIF and SCAIF compare favorably to FF for some specific indications achieving similar outcomes at a lower cost.
本综述重点关注肿瘤切除后游离皮瓣（FF）与带蒂皮瓣（PF）重建的对比研究。
本研究按照 PRISMA 指南进行系统评价，并使用 Pubmed、Medline、EMBASE、Amed 和 Biosis 数据库进行检索。
共纳入 30 篇文章。与 PF 相比，FF 手术时间更长、费用更高、术后修正率更高。FF 与锁骨下动脉岛状皮瓣（SCAIF）相比，入住重症监护病房的时间更长，与颏下岛状皮瓣（SMIF）相比，住院时间更长。FF 与胸大肌肌皮瓣（PMMF）相比，感染和坏死的发生率更低。
由于纳入研究的固有设计，两种皮瓣的比较受到限制。总的来说，FF 在多个结果上优于 PMMF。SMIF 和 SCAIF 在某些特定适应证上与 FF 相比具有优势，可在降低成本的同时获得相似的效果。
