游离皮瓣与带蒂皮瓣用于手部重建：一项系统评价与荟萃分析。
Free versus pedicled flaps for hand reconstruction: A systematic review and meta-analysis.
作者信息
Alzahrani Haya Abdulaziz, Asiri Mohammed Nasser, Humedi Abdulsalam M, Alammar Juman, Alrashed Hajar, Hakami Faisal
机构信息
Faculty of Medicine, Al-Baha University, Jeddah, Saudi Arabia.
Assistant Professor of Plastic, Reconstructive, and Hand Surgery, Department of Surgery, Faculty of Medicine, Al-Baha University, Al-Baha, Saudi Arabia.
出版信息
JPRAS Open. 2025 May 16;45:278-288. doi: 10.1016/j.jpra.2025.05.004. eCollection 2025 Sep.
BACKGROUND
Hand reconstruction is a critical component of plastic surgery, addressing congenital, traumatic, and degenerative conditions. Free and pedicled flaps are commonly used for hand defect repair.
AIM
This systematic review was to compare the outcomes of free versus pedicled flaps in hand reconstruction.
METHODS
a search was conducted in October 2024 across PubMed, Web of Science, and Ovid MEDLINE using keywords such as "free tissue flaps," "pedicled flaps," and "hand reconstruction." Eligible studies included randomized controlled trials, cohort studies, and clinical trials. Data on flap survival, complications, and patient satisfaction were extracted independently.
RESULTS
Nine studies involving 839 hands were included. Free flaps had a lower revision surgery rate (24 % vs. 61 %), while pedicled flaps showed fewer infections (8 % vs. 13 %) and less flap necrosis (8 % vs. 9 %).
CONCLUSION
Free flaps offer lower revision rates, while pedicled flaps present fewer complications. This systematic review represents level III evidence
背景
手部重建是整形外科的关键组成部分，可解决先天性、创伤性和退行性疾病。游离皮瓣和带蒂皮瓣常用于手部缺损修复。
目的
本系统评价旨在比较游离皮瓣和带蒂皮瓣在手部重建中的效果。
方法
2024年10月，在PubMed、科学网和Ovid MEDLINE数据库中进行检索，使用“游离组织皮瓣”、“带蒂皮瓣”和“手部重建”等关键词。符合条件的研究包括随机对照试验、队列研究和临床试验。独立提取皮瓣存活、并发症和患者满意度的数据。
结果
纳入9项研究，涉及839只手。游离皮瓣的翻修手术率较低（24%对61%），而带蒂皮瓣的感染较少（8%对13%），皮瓣坏死也较少（8%对9%）。
结论
游离皮瓣的翻修率较低，而带蒂皮瓣的并发症较少。本系统评价为III级证据
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