{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T11:14:47Z","timestamp":1780485287158,"version":"3.54.1"},"reference-count":27,"publisher":"Georg Thieme Verlag KG","issue":"08","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Reconstr Microsurg"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003Combined revascularization and free flap reconstruction is one treatment method for chronic limb-threatening ischemia (CLTI) with complex wounds. The purpose of this systematic review and meta-analysis was to investigate the characteristics of this combined procedure and to assess postoperative outcomes.<\/jats:p><jats:p>\n          Methods\u2003A systematic search was performed across PubMed, Scopus, and the Web of Science for studies between January 2000 and February 2022. A random-effects meta-analysis for postoperative outcome was conducted.<\/jats:p><jats:p>\n          Results\u2003Fifteen articles encompassing 1,176 patients with 1,194 free flaps were ultimately included in the qualitative and quantitative assessment. Our meta-analysis showed the following complication rates for short-term postoperative outcomes: 37% (95% confidence interval [CI], 18\u201353%; I\n          2\u2009=\u200974%) for reoperation, 13% (95% CI, 2\u201324%; I\n          2\u2009=\u20090%) for vascular thrombosis, 9% (95% CI, 0\u201317%; I\n          2\u2009=\u20090%) for total flap failure, 8% (95% CI, 0\u201317%; I\n          2\u2009=\u20090%) for partial flap failure, 4% (95% CI, 0\u201310%; I\n          2\u2009=\u20090%) for amputation, and 3% (95% CI, 0\u20139%; I\n          2\u2009=\u20090%) for 30-day mortality. The 1-, 3-, and 5-year limb salvage rates were 86% (95% CI, 78\u201392%), 81% (95% CI, 68\u201388%), and 71% (95% CI, 53\u201383%), respectively. The 1-, 3-, and 5-year patient survival rates were 93% (95% CI, 90\u201396%), 92% (95% CI, 77\u201397%), and 75% (95% CI, 50\u201388%), respectively.<\/jats:p><jats:p>\n          Conclusion\u2003Combined revascularization and free flap reconstruction for CLTI with complex wounds was clearly effective for the long-term outcomes. However, this combined procedure should be considered on the assumption that the reoperation rate is high and that flap-related complications rate may be higher than lower extremity reconstruction of other etiologies.<\/jats:p>","DOI":"10.1055\/a-2003-9004","type":"journal-article","created":{"date-parts":[[2022,12,29]],"date-time":"2022-12-29T00:03:21Z","timestamp":1672272201000},"page":"581-588","source":"Crossref","is-referenced-by-count":4,"title":["Combined Revascularization and Free Flap Reconstruction for Chronic Limb-Threatening Ischemia: A Systematic Review and Meta-Analysis"],"prefix":"10.1055","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0761-4147","authenticated-orcid":false,"given":"Keisuke","family":"Shimbo","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Hiroshima Prefectural Hospital, Hiroshima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haruka","family":"Kawamoto","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Hiroshima Prefectural Hospital, Hiroshima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isao","family":"Koshima","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Hiroshima University Hospital, Hiroshima, Japan"},{"name":"International Center for Lymphedema, Hiroshima University Hospital, Hiroshima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2023,1,19]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"S1, 109.e33","DOI":"10.1016\/j.ejvs.2019.05.006","article-title":"Global vascular guidelines on the management of chronic limb-threatening ischemia","volume":"58","author":"M S Conte","year":"2019","journal-title":"Eur J Vasc 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