Background: Unconventional perfusion
flaps offer multiple potential advantages compared with traditional flaps.
Although there are numerous experimental articles on unconventional perfusion
flaps, the multiple animal species involved, the myriad vascular constructions
used, and the frequently conflicting data reported make synthesis of this
information challenging. The main aim of this study was to perform a systematic
review and meta-analysis of the literature on the experimental use of
unconventional perfusion flaps, to identify the best experimental models
proposed and to estimate their global survival rate.
Methods: The authors performed a
systematic review and meta-analysis of all articles written in English, French,
Italian, Spanish, and Portuguese on the experimental use of unconventional
perfusion flaps and indexed to PubMed from 1981 until February 1, 2017.
Results: A total of 68 studies were
found, corresponding to 86 optimized experimental models and 1073
unconventional perfusion flaps. The overall unconventional perfusion flap
survival rate was 90.8 percent (95 percent CI, 86.9 to 93.6 percent; p <
0.001). The estimated proportion of experimental unconventional perfusion flaps
presenting complete survival or nearly complete survival was 74.4 percent (95
percent CI, 62.1 to 83.7 percent; p < 0.001). The most commonly reported
animal species in the literature were the rabbit (57.1 percent), the rat (26.4
percent), and the dog (14.3 percent). No significant differences were found in
survival rates among these species, or among the diverse vascular patterns
used.
Conclusion: These data do not differ
significantly from those reported regarding the use of unconventional perfusion
flaps in human medicine, suggesting that rabbit, rat, and canine experimental
unconventional perfusion flap models may adequately mimic the clinical
application of unconventional perfusion flaps.
