Indications, Postoperative Outcomes, and Complications of the Lateral Arm Free Flap: A Systematic Review and Meta-analysis.

Background: The lateral arm free flap (LA-FF) has become an increasingly popular choice in the reconstruction of soft tissue defect in many anatomical regions. However, there is a paucity of literature regarding its safety and efficacy. The aim of this study is to analyze its different applications along with their surgical outcomes.

Methods: A systematic review including all studies assessing the surgical outcomes of the LA-FF and proportional meta-analysis using a random-effect DerSimonian-Laird model was performed to assess the postsurgical complications and flap failures.

Results: Twenty-five articles were included in the final analysis, representing a total of 1272 flaps in 1256 patients. Indications were mainly defects following tumoral resection and trauma. Across the different studies, the reported flap size range varied from 2 × 4 cm to 12 × 16 cm. The overall pooled flap failure rate across all indications was 3% [95% confidence interval (CI), 0.01-0.04], with a pooled failure rate of 2% (95% CI, 0.01-0.04) in the head and neck region, 3% (95% CI, 0.01-0.06) in the upper limb region, and 3% (95% CI, 0.01-0.06) in studies evaluating its use in different anatomical locations. The overall donor site complication rate was 11% (95% CI, 0.03-0.21), with no major complications described.

Conclusions: This meta-analysis demonstrates safety and efficacy of the LA-FF in reconstructing moderate to large soft tissue defects. It is mainly used for head and neck posttumoral resection and upper and lower limb posttraumatic reconstruction.