背景:血管手术中的腹股沟伤口感染仍然是一个常见的并发症和具有挑战性的问题。本系统评价旨在建立一个完整的观点,即使用肌瓣进行血管外科重建后感染腹股沟伤口的患者特征和临床结果,并评估缝匠肌瓣(SMF)之间的结果差异。股直肌肌皮瓣(RFF),和股薄肌皮瓣(GMF)。
方法:PubMed,Scopus,从成立到2021年4月,对WebofScience进行了系统搜索。对合并症和结局进行随机效应荟萃分析,对结局进行亚组分析。
结果:30项研究纳入了定性和定量综合研究。总体汇总数据显示以下结局率:4.5%的肌瓣坏死(95%置信区间[CI],-3.4-12.3%;I2=0%),总并发症21.8%(95%CI,15.8-27.7%;I2=0%),8.0%肢体丢失(95%CI,1.9-14.1%;I2=0%),移植物损失15.4%(95%CI,5.0-25.3%;I2=37.9%),30天死亡率为7.4%(95%CI,-.9-15.6%;I2=0%)。总并发症发生率为20.3%(95%CI,12.1-28.2%;I2=0%),23.2%(95%CI,11.2-34.5%;I2=10.2%),SMF为18.0%(95%CI,-3.537.8%;I2=0%),RFF,和GMF,分别。GMF的肢体丢失率最高(17.2%;95%CI,-4.237.2%;I2=0%)。RFF的移植物损失率最高(20.7%;95%CI,.6-39.1%;I2=53.9%)。SMF的30天死亡率最低(5.3%;95%CI,-6.1-16.6%;I2=0%)。
结论:对于血管外科术后腹股沟感染伤口,肌瓣重建的有效性和安全性显然是积极的。这篇综述表明,SMF的并发症发生率低于其他肌肉皮瓣。
BACKGROUND: Groin wound infections in vascular surgery are still a common complication and challenging problem. This systematic
review aimed to establish a complete view of patient characteristics and clinical outcomes for infected groin wounds following vascular surgery reconstruction using muscle flaps and to evaluate the differences in outcomes between the sartorius muscle flap (SMF), rectus femoris muscle flap (RFF), and gracilis muscle flap (GMF).
METHODS: PubMed, Scopus, and Web of Science were systematically searched from inception to April 2021. Random-effects meta-analysis for comorbidities and outcomes and subgroup analyses for outcomes were performed.
RESULTS: Thirty studies were included in qualitative and quantitative syntheses. Overall pooled data showed the following outcome rates: 4.5% muscle flap necrosis (95% confidence interval [CI], -3.4-12.3%; I2 = 0%), 21.8% overall complications (95% CI, 15.8-27.7%; I2 = 0%), 8.0% limb loss (95% CI, 1.9-14.1%; I2 = 0%), 15.4% graft loss (95% CI, 5.0-25.3%; I2 = 37.9%), and 7.4% 30-day mortality (95% CI, -.9-15.6%; I2 = 0%). The rates of overall complications were 20.3% (95% CI, 12.1-28.2%; I2 = 0%), 23.2% (95% CI, 11.2-34.5%; I2 = 10.2%), and 18.0% (95% CI, -3.537.8%; I2 = 0%) for the SMF, RFF, and GMF, respectively. The rate of limb loss was highest for the GMF (17.2%; 95% CI, -4.237.2%; I2 = 0%). The rate of graft loss for the RFF was the highest (20.7%; 95% CI, .6-39.1%; I2 = 53.9%). The rate of 30-day mortality was the lowest for the SMF (5.3%; 95% CI, -6.1-16.6%; I2 = 0%).
CONCLUSIONS: The effectiveness and safety of muscle flap reconstruction for infected groin wounds following vascular surgery are clearly positive. This
review indicated a tendency for lower complication rates with the SMF than with other muscle flaps.