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The vascularised forearm free flap is a workhorse flap for the reconstruction of many types of soft tissue defects. However, the difference in donor-site morbidity between the radial forearm free flap (RFFF) and ulnar forearm free flap (UFFF) remains controversial. This study aimed to compare the donor-site outcomes of RFFF and UFFF. We searched PubMed, EMBASE, Web of Science, clinicaltrials.gov, Cochrane Library, and Chinese Biomedical Literature Database up to August 10, 2021, to identify studies on donor-site outcomes of RFFF versus UFFF in patients undergoing reconstructive surgery. Two authors individually extracted data and performed quality assessments of the selected articles. The overall morbidity and overall effect of individual complications of the donor site were analysed. In total, 288 cases from five studies were included in our analysis. The UFFF group was significantly superior to the RFFF group regarding overall morbidity and overall effect of individual complications of the donor site. The morbidity of UFFF donor sites was significantly lower than that of RFFF, and UFFF may be an ideal substitute for RFFF in reconstructive surgery. However, additional large-scale studies are necessary to confirm this finding., (Copyright © 2021 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.)

Background: Adequate flap volume is key to maintaining oral function after oral cancer surgery. This study aimed to evaluate changes in radial forearm free flap (RFFF) volumes after 1 year of follow-up following ablative tumor surgery in the head and neck., Methods: A prospective study that recorded the clinical data of 20 patients with head and neck cancer who underwent RFFF reconstruction. Magnetic resonance (MR) and Mimics Research 19.0 software were used to measure the RFFF volumes at 1, 3, 6, and 12 postoperative months., Results: Compared with one postoperative month, the RFFF volume decreased by 15.5%, 29.4%, and 42.0% at 3, 6, and 12 months, respectively, after surgery. A significant positive correlation between postoperative radiotherapy and RFFF volume changes was detected., Conclusion: The volume of RFFF decreases with time. It is recommended to use overcorrection, with a 40% increase in RFFF volume, to reconstruct head and neck tumor-related defects., (© 2021 Wiley Periodicals LLC.)

Background: With the gradual popularity of relatively novel medial sural artery perforator flap (MSAPF), robust studies are needed to compare the surgical outcomes of MSAPF versus multiple free soft flaps (MFSFs) to verify the advantages and disadvantages of MSAPF., Methods: The authors searched PubMed, Web of Science, EMBASE, Cochrane Library, Chinese BioMedical Literature Database (CBM), and China National Knowledge Infrastructure (CNKI) until September, 2020, to identify studies that compared surgical outcomes of MSAPF and MFSFs. Two authors followed the PRISMA guidelines, individually extracted the data and performed the quality assessments. Survival rate of flaps, satisfaction degree of patients in recipient and donor site, skin grafting, and morbidity of recipient and donor site were evaluated., Results: A total of 441 cases from 7 studies were included in our analysis. No significant differences were found regarding survival rate of flaps, recipient morbidity, and recipient satisfaction degree between the 2 groups. However, MSAPF group was significantly superior to MFSFs group in terms of skin grafting, morbidity, and satisfaction degree of donor site., Conclusion: Our meta-analysis showed that the MSPAF and MFSFs groups were similar in terms of survival rate of flaps, recipient morbidity, and recipient satisfaction degree. Medial sural artery perforator flap group was superior to MFSFs group in terms of morbidity and satisfaction degree of donor site. The results may prove that MSAPF is gaining popularity for a reason and is a good choice for repairing soft tissue defects., Competing Interests: The authors report no conflicts of interest., (Copyright © 2020 by Mutaz B. Habal, MD.)