{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T04:04:51Z","timestamp":1792123491650,"version":"4.4.0"},"reference-count":45,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,8,15]],"date-time":"2025-08-15T00:00:00Z","timestamp":1755216000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,8,15]],"date-time":"2025-08-15T00:00:00Z","timestamp":1755216000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Microsurgery"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Contracture recurrence is a common setback to burn reconstruction, especially for severe or large\u2010area contractures. Flap\u2010based burn reconstruction has been shown to result in lower recurrent contracture rates. This study aims to summarize and evaluate the outcomes of flap\u2010based techniques used for post\u2010burn joint contracture reconstruction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic review was performed following PRISMA guidelines. Databases searched included PUBMED, EMBASE, Scopus, and Web of Science. Articles that described the use of flaps with a known blood supply to reconstruct post\u2010burn contractures of the joints were included. Studies with incomplete data, with multiple anatomic site contracture involvement, case reports, and non\u2010English articles were excluded. Data on patient demographics, flap type, complications, and contracture resolution were extracted. A proportional meta\u2010analysis was conducted using the DerSimonian and Laird random\u2010effects model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Out of 850 studies screened, 27 met inclusion criteria. Reconstruction of 830 joint contractures was reported. Contractures resolved for 98.9% (\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090% [95% CI: 97.7\u201399.6]) of pedicled and 90.1% (\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200982.8% [95% CI: 62.7\u2013100]) of free flap reconstructions, recurring in 1.8% (\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090% [95% CI: 0.7\u20133.3]) at sites reconstructed with pedicled flaps and 0.6% (\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090% [95% CI: 0.1\u20131.7]) at sites reconstructed with free flaps. The rates of flap complications were low, with total flap loss reported at 1.5% (\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090% [95% CI: 0.6\u20132.7]) and 2.9% (\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200937.9% [95% CI: 0.9\u20135.8]) of the time for pedicled and free flaps, respectively. Partial flap loss was 6.9% (\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200965.1% [95% CI: 3.4\u201311.5]) and 5.2% (\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200965% [95% CI: 1.7\u201310.4]) for pedicled and free flaps, respectively. No significant difference was identified in rates of contracture resolution (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.50), contracture recurrence (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.15), total flap loss (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.18) or partial flap loss (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.31) regardless of the flap type used.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Burn contracture reconstruction using flap\u2010based techniques shows minimal complications and low rates of contracture recurrence when used for joints. Pedicled and free flap reconstruction of burn contracture sites yield similar outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/micr.70104","type":"journal-article","created":{"date-parts":[[2025,8,16]],"date-time":"2025-08-16T06:40:11Z","timestamp":1755326411000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Outcomes of Microsurgical Reconstruction of Post\u2010Burn Joint Contracture\u2014Systematic Review and Meta\u2010Analysis"],"prefix":"10.1002","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-8891-6162","authenticated-orcid":false,"given":"Abdulaziz","family":"Elemosho","sequence":"first","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, College of Medicine The Ohio State University Wexner Medical Center  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Layne N.","family":"Raborn Macdonald","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery University of Rochester Medical Center  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derek E.","family":"Bell","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery University of Rochester Medical Center  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey E.","family":"Janis","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, College of Medicine The Ohio State University Wexner Medical Center  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,8,15]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199493030-00009"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2017.05.047"},{"issue":"4","key":"e_1_2_10_4_1","first-page":"337","article-title":"Reconstruction of Burn Contractures With Free Anterolateral Thigh Flap in Various Anatomic Sites","volume":"27","author":"Bali Z. 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