TY  - JOUR
AU  - Alharbi, Ziyad
PY  - 2025
DA  - 2025/01/13
TI  - Efficiency of Pre-Expanded Anterior Supraclavicular Artery Pedicled Skin Flaps: A Meta-Analysis Study
JO  - OBM Transplantation
SP  - 231
VL  - 09
IS  - 01
AB  - The supraclavicular artery flap presents a promising solution for facial reconstruction challenges since 1997, surpassing limitations of traditional methods like the deltopectoral flap. Its extended pedicle and thin, pliable epidermis offer reliable outcomes with minimal donor site morbidity, making it a preferred choice for head and neck reconstruction. This systematic review evaluates the efficacy of pre-expanded supraclavicular artery flaps based on a comprehensive analysis. In accordance with the Preferred Reporting Items for Meta-Analysis (PRISMA) recommendations, this meta-analysis was carried out. A comprehensive search of electronic databases including PubMed, Google Scholar and Web of Science between 2013-2024. The search strategy utilized the following keywords: ["supraclavicular" AND "flap"]. Searches were limited to English-language articles. We also manually searched reference lists of relevant articles to identify additional studies. The inclusion criteria for the articles were as follows: (1) original research articles discussing the use of Pre-Expanded Anterior Supraclavicular Artery Pedicled Flaps; (2) English language publications; (3) human subject studies; and (4) studies reporting pertinent outcomes like flap viability, complications, or aesthetic results. Free, thoracic, deltoid and pectoral flaps were excluded. Reviews and studies written in languages other than English were eliminated. To determine the eligibility of the initial pool of 202 studies that were gathered from different sources, a rigorous screening procedure was carried out. Nine publications were subjected to a thorough full-text evaluation following the exclusion of 193 research studies that did not match the inclusion requirements. After this evaluation, only seven papers were deemed suitable for this meta analysis's inclusion. All studies reported successful outcomes of the flap procedures, indicating the effectiveness of pre-expanded anterior supraclavicular artery pedicled skin flaps in the sample. Wound healing outcomes varied across the studies, with 42.9% reporting excellent wound healing and 57.1% reporting good wound healing. This suggests overall favourable outcomes in terms of wound healing. Expansion in the area of the lifting site increases flap size and allows reconstruction of more extensive facial and neck defects in terms of function and aesthetics. The advantages of the pre-expansion are well reported and include the minor donor site morbidity, flap safety and reliability, and most importantly, its favorable match in color and texture to tissue of the head and neck area in addition to vascularity. Pre-expansion not only increases size and reduces thickness, but also enhances the vascularization process through a well-formed capsule enriched with vessels. Primary closure of the donor site can be achieved with tensionless technique due to the laxity of the skin after expander insertion.
SN  - 2577-5820
UR  - https://doi.org/10.21926/obm.transplant.2501231
DO  - 10.21926/obm.transplant.2501231
ID  - Alharbi2025
ER  -