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Comparative Study
. 2019 Mar 14;48(1):13.
doi: 10.1186/s40463-019-0334-y.

Free versus pedicled flaps for reconstruction of head and neck cancer defects: a systematic review

Fanny Gabrysz-Forget  1 , Paul Tabet  1 , Akram Rahal  2 , Eric Bissada  2 , Apostolos Christopoulos  2 , Tareck Ayad  3   4
Affiliations
Comparative Study

Free versus pedicled flaps for reconstruction of head and neck cancer defects: a systematic review

Fanny Gabrysz-Forget et al. J Otolaryngol Head Neck Surg. .

Abstract

Objective: The present review focuses on comparative studies of reconstruction with free flaps (FF) versus pedicled flaps (PF) after oncologic resection.

Method: A systematic review was developed in compliance with PRISMA guidelines and performed using the Pubmed, Medline, EMBASE, Amed and Biosis databases.

Results: 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).

Conclusion: 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.

Keywords: Flaps; Oncology; Outcomes; Reconstruction; Surgery.

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Conflict of interest statement

Ethics approval and consent to participate

Not applicable.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

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Figures

Fig. 1
Fig. 1
PRISMA flow diagram presenting the systematic review process
See this image and copyright information in PMC

References

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