Comparative study of microvascular anastomostic device and hand-sewn in free flap repair of soft tissue defects: a Meta analysis based on PRISMA principle / 中华显微外科杂志

ABSTRACT

Objective:To compare the efficacy and safety between microvascular anastomostive device (MAD) and hand-sewn (HS) in free flap reconstruction.Methods:Databases in Pubmed, Embase, CNKI, Wanfang, CBM and Weipu etc. The comparative study of MAD device and manual suture in free flap repair of soft tissue defects published in domestic and foreign official journals from January, 1950 to October, 2019 was collected. The quality of the included studies was strictly evaluated and relevant data were extracted. Revman 5.3 software was used to analyze all relevant data.Results:Fifteen trials with 5 539 patients were included. There was significant difference between MAD and HS in time of venous anastomoses ( SMD=-5.46, 95% CI -7.50, -3.41, P<0.001), time of artery anastomoses ( SMD=-5.16, 95% CI -9.61, -0.71, P=0.02), vascular crisis ( RR=0.49, 95% CI 0.34, 0.70, P<0.001) and flap necrosis ( RR=0.52, 95% CI 0.32, 0.86, P=0.01), the difference between the 2 groups was statistically significant ( P< 0.05). Conclusion:According to the analyses of the pooled results of MAD group and HS group, the data tend to suggest that MAD is superior to HS in the reconstruction with free flap.