Is double venous anastomosis better than single venous anastomosis in head and neck reconstruction with free flaps? A systematic review and meta-analysis.
R J Sánchez-Moreno, R Labrador-Carrillo, R González-García et al.
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In 30 seconds
This systematic review and meta-analysis evaluated the efficacy of double venous anastomosis (DVA) versus single venous anastomosis (SVA) in head and neck reconstruction using free flaps, involving 9996 flaps. The study found that the odds of flap loss were significantly higher in the SVA group (odds ratio 1.49, 95% confidence interval 1.07-1.84; P = 0.018), suggesting a potential benefit of DVA.
Key findings
- The overall success rate of flap procedures was 97.09%.
- The odds of flap loss were significantly higher in the SVA group (odds ratio 1.49).
- Venous congestion and surgical revision rates were lower in the DVA group.
Why it matters
Understanding the impact of venous anastomosis techniques on flap survival is crucial for improving surgical outcomes in head and neck reconstruction, where flap loss can lead to significant complications.
What to keep in mind
Most included studies were retrospective, and pooled estimates were based on unadjusted data, limiting the strength of the conclusions.