The Vastus Lateralis Free Flap and Donor-Site Morbidity. A Systematic Review

Abstract

Study Design: Systematic review. Objective: Vastus lateralis is used to reconstruct defects in the head and neck. While the advantages are documented, donor-site morbidity requires further investigation. Before an investigation can commence, a review of the literature is required. The aim of this study was to review the existing evidence regarding the use of the vastus lateralis flap and donor-site morbidity. The results from this study will assist to determine further research and need for preventative and post-operative options to improve patient care and health outcomes. Methods: Electronic databases were searched (in January-February 2020). Peer-reviewed, English language articles were included if they investigated the association between the vastus lateralis flap and donor-site related health outcome. Two reviewers independently screened and assessed the articles. The risk of bias of each individual study was assessed using the Cochrane risk of bias assessment for observational and intervention studies. Results: Five articles representing 97 participants from 4 countries were included. The vastus lateralis flap (head and neck reconstruction) was shown to have a neutral association with donor-site leg strength, ability to climb stairs, walking and activities of daily living. Minor negative associations was found for changes in sensation and bruising. Conclusion: Current research reports a neutral effect between the use of the vastus lateralis and donor-site morbidity. Further research is required using a more rigorous investigative approach using a wider range of objective measures and larger sample sizes to confirm these findings to inform holistic post-operative care options.