Current concepts in scapular free flap reconstruction.
Omar Sheikh, Samyukta Sundar, Laura Wingfield et al.
✦ AI-curated · Sources linked
In 30 seconds
This PROSPERO-registered systematic review examined scapular free flap harvesting, success, and complications in the literature on head and neck reconstruction. Fifty papers were included. The pooled flap success rate was 97.25%. Reported complications included seroma, donor-site infection, fistula, and plate exposure; reduced mobility was the main donor-site complaint. The review also describes the versatility of the scapular system, including vascular axes that can support two skin paddles and one bone paddle for complex defects.
Key findings
- Across 50 included papers, the pooled scapular free flap success rate was 97.25%.
- Reported complications included seroma, donor-site infection, fistula, and plate exposure.
- Reduced mobility was the primary donor-site complaint.
Why it matters
Scapular system flaps can provide multiple tissue components for complex head and neck defects, and the review reports a high pooled success rate. Awareness of donor-site mobility concerns and other reported complications can inform reconstruction discussions and postoperative assessment, while the evidence should be interpreted in light of incomplete complication reporting.
What to keep in mind
Not all included studies reported complications, so complication estimates may be affected by reporting bias.