背景:桡骨前臂游离皮瓣(RFFF)是各种重建的主力。尽管RFFF抬高后有多种手术技术可用于供体部位的闭合,最常见的技术是使用分层厚度皮肤移植(STSG)或全厚度皮肤移植(FTSG)进行闭合.闭合可导致前臂和手的伤口并发症和功能以及美学损害。计划的系统评价和荟萃分析的目的是比较与伤口相关的功能相关和美学相关的结果与全厚度皮肤移植物(FTSG)和分裂厚度皮肤移植物(STSG)在radial前臂游离皮瓣(RFFF)供体部位闭合。
方法:将进行系统评价和荟萃分析。将遵循系统审查和荟萃分析(PRISMA)指南的首选报告项目。电子数据库和平台(PubMed,Embase,Scopus,WebofScience,Cochrane中央对照试验登记册(中央),中国国家知识基础设施(CNKI)和临床试验注册(ClinicalTrials.gov,德国临床试验注册,ISRCTN注册表,国际临床试验注册平台)将使用预定义的搜索词进行搜索,直到2024年1月15日。重新搜索将在审查发表前12个月内进行。符合条件的研究应报告在提高RFFF和缺损闭合后供体部位并发症的发生。包括的闭合技术是使用全厚度皮肤移植物和分裂厚度皮肤移植物的技术。排除的闭合技术是不使用皮肤移植物的初次伤口闭合。结果被认为是受伤的-,功能-,和美学相关。将纳入的研究是随机对照试验(RCTs)以及前瞻性和回顾性比较队列研究。病例对照研究,没有对照组的研究,动物研究和尸体研究将被排除在外。每个研究将由两名审阅者以盲法方式进行筛选。第三位审稿人解决差异。将使用ROBINS-I和RoB2工具评估原始研究中的偏倚风险。使用ReviewManager(RevMan)5.4.1完成数据合成。如果合适,将进行荟萃分析。研究之间的变异性将使用I2指数进行评估。如有必要,将使用R。结果的证据质量最终将使用建议分级评估来评估,开发和评估(等级)方法。
结论:这项研究的发现可能有助于我们了解两种闭合技术的并发症发生率,并可能对未来RFFF供体部位管理指南的制定具有重要意义。如果可用数据有限,并且有几个问题仍未得到回答,将需要更多的比较研究。
背景:该协议是根据PRISMA-P协议扩展而开发的,并于2023年9月17日在国际前瞻性系统审查登记册(PROSPERO)注册(注册号CRD42023351903)。
BACKGROUND: The radial forearm free flap (RFFF) serves as a workhorse for a variety of reconstructions. Although there are a variety of surgical techniques for donor site closure after RFFF raising, the most common techniques are closure using a split-thickness skin graft (STSG) or a full-thickness skin graft (FTSG). The closure can result in wound complications and function and aesthetic compromise of the forearm and hand. The aim of the planned systematic
review and meta-analysis is to compare the wound-related, function-related and aesthetics-related outcome associated with full-thickness skin grafts (FTSG) and split-thickness skin grafts (STSG) in radial forearm free flap (RFFF) donor site closure.
METHODS: A systematic
review and meta-analysis will be conducted. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines will be followed. Electronic databases and platforms (PubMed, Embase, Scopus, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), China National Knowledge Infrastructure (CNKI)) and clinical trial registries (ClinicalTrials.gov, the German Clinical Trials Register, the ISRCTN registry, the International Clinical Trials Registry Platform) will be searched using predefined search terms until 15 January 2024. A rerun of the search will be carried out within 12 months before publication of the
review. Eligible studies should report on the occurrence of donor site complications after raising an RFFF and closure of the defect. Included closure techniques are techniques that use full-thickness skin grafts and split-thickness skin grafts. Excluded techniques for closure are primary wound closure without the use of skin graft. Outcomes are considered wound-, functional-, and aesthetics-related. Studies that will be included are randomized controlled trials (RCTs) and prospective and retrospective comparative cohort studies. Case-control studies, studies without a control group, animal studies and cadaveric studies will be excluded. Screening will be performed in a blinded fashion by two reviewers per study. A third reviewer resolves discrepancies. The risk of bias in the original studies will be assessed using the ROBINS-I and RoB 2 tools. Data synthesis will be done using
Review Manager (RevMan) 5.4.1. If appropriate, a meta-analysis will be conducted. Between-study variability will be assessed using the I2 index. If necessary, R will be used. The quality of evidence for outcomes will eventually be assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.
CONCLUSIONS: This study\'s findings may help us understand both closure techniques\' complication rates and may have important implications for developing future guidelines for RFFF donor site management. If available data is limited and several questions remain unanswered, additional comparative studies will be needed.
BACKGROUND: The protocol was developed in line with the PRISMA-P extension for protocols and was registered with the International Prospective Register of Systematic Reviews (PROSPERO) on 17 September 2023 (registration number CRD42023351903).