Surgical outcomes of profunda artery perforator flap in head and neck reconstruction: A systematic review and meta‐analysis

Abstract

AbstractObjectiveThis study aims to evaluate the efficacy of the profunda artery perforator (PAP) flap in head and neck reconstruction.MethodsA single arm meta‐analysis was performed for flap survival rate (primary outcome), reoperation for major complication, and overall complication rates (secondary outcomes).ResultsThe search strategy yielded a total of 295 potentially relevant publications, of which 13 were included. A total of 305 patients (males: 80.8%, n = 232/281), with a median age of 56.1 years (n = 305/305; 95% CI 53.9–63), who underwent a total of 307 PAP flap reconstructions for head and neck defects were included. Flap survival rate was 100% (n = 306/307; 95% CI 99.6%–100%), with a reoperation rate for major complications of 3.7% (n = 15/307; 95% CI 1.85%–6.1%) and an overall complication rate of 26.5% (n = 92/307; 95% CI 15.7%–38.9%). Notable postoperative complications included wound dehiscence (n = 15/307, 4.9%), delayed healing (n = 14/307, 4.6%), and wound infection (n = 12/307, 3.9%). Partial flap necrosis and hematoma occurred in 2.6% of cases (n = 8/307), while arterial and venous thrombosis were documented in 0.7% (n = 2/307) and 1.3%, respectively (n = 4/307).ConclusionThe application of the PAP flap in head and neck reconstructions showed several favorable aspects, such as an exceptionally low flap failure rate, versatility in achieving variable dimensions, and a relatively low incidence of complications. PAP flap might be considered as a compelling alternative to the traditionally employed soft tissue free flaps in head and neck reconstruction.