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However, its use in reconstructive microsurgery has not been comprehensively characterized. This systematic review and meta\u2010analysis aim to assess the key features and outcomes of the PFF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The study protocol followed the PRISMA guidelines. Multiple online databases were used to identify articles published through 2024. Studies including patients who underwent PFF procedures were eligible. A two\u2010stage screening process was conducted for study selection. Data extraction focused on the primary outcome (failure rate), secondary outcomes (other complications), and additional information. An analysis of pooled data was performed to evaluate rates of complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eighty\u2010four articles were included in this review. A total of 647 patients and 664 PFFs were identified; among these, 57.38% were harvested solely as PFFs, while 42.62% involved combinations with other free flaps. The predominant recipient site was the head and neck, accounting for 72.52% of cases. The leading indications were malignancy (28.64%), post\u2010burn scarring (17.35%), and trauma (13.26%). Meta\u2010analysis of the primary outcome revealed no heterogeneity across the studies (<jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u20090.00%; <jats:italic>Q<\/jats:italic> statistic 17.50, <jats:italic>p<\/jats:italic>\u2009=\u20090.56), with a pooled failure rate of 0.99% (95% CI: 0%\u20132.63%). Other complication rates included partial necrosis (2.09%, 95% CI: 0%\u20135.45%), hematoma (5.18%, 95% CI: 1.34%\u201310.63%), wound dehiscence (5.98%, 95% CI: 0.38%\u201315.47%), infection (0.86%, 95% CI: 0.00%\u20133.97%), and venous thrombosis (1.57%, 95% CI: 0.00%\u20134.95%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The PFF is a versatile and reliable option in reconstructive microsurgery, offering low failure rates and minimal complications. Its applicability across various anatomical regions and indications makes it an invaluable option for microsurgeons.<\/jats:p><\/jats:sec>","DOI":"10.1002\/micr.70099","type":"journal-article","created":{"date-parts":[[2025,7,25]],"date-time":"2025-07-25T10:14:29Z","timestamp":1753438469000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Outcomes of Parascapular Free Flap in Reconstructive Microsurgery: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1002","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-8206-0448","authenticated-orcid":false,"given":"Agustin N.","family":"Posso","sequence":"first","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery Beth Israel Deaconess Medical Center, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Audrey","family":"Mustoe","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery Beth Israel Deaconess Medical Center, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria J.","family":"Escobar\u2010Domingo","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery Beth Israel Deaconess Medical Center, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Thomas","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery Beth Israel Deaconess Medical Center, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jade E.","family":"Smith","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery Beth Israel Deaconess Medical Center, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose","family":"Foppiani","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery Beth Israel Deaconess Medical Center, Harvard Medical School  Boston Massachusetts USA"},{"name":"Division of Plastic and Reconstructive Surgery University of Minnesota Health, University of Minnesota  Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorien I.","family":"Schonebaum","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery Beth Israel Deaconess Medical Center, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noelle","family":"Garbaccio","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery Beth Israel Deaconess Medical Center, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel J.","family":"Lin","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery Beth Israel Deaconess Medical Center, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5533-3166","authenticated-orcid":false,"given":"Bernard T.","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery Beth Israel Deaconess Medical Center, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,25]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199705010-00014"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/ans.14240"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.30335"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/0007\u20101226(84)90048\u20101"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.30640"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcms.2007.07.005"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.sap.0000210626.64620.bc"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097\u20100347(199710)19:7<620::AID\u2010HED10>3.0.CO;2\u20106"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3181ea93ad"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.burns.2020.04.001"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000002911"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0007\u20101226(66)80003\u20106"},{"key":"e_1_2_10_14_1","unstructured":"Buntic R.2025. 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