{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:28:04Z","timestamp":1785457684251,"version":"3.56.0"},"reference-count":0,"publisher":"Georg Thieme Verlag KG","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J reconstr Microsurg"],"published-print":{"date-parts":[[2018,5]]},"abstract":"<jats:p>\n            Background\u2003In 1986, Marko Godina published his seminal work regarding the timing of free-flap reconstruction for traumatic extremity defects. Early reconstruction, compared with delayed and late reconstruction resulted in significant decreases in free-flap failure rate, post-operative infections, hospitalization time, bone healing time, and number of additional anesthesias. The objective of this manuscript was to evaluate whether these principles continue to apply.<\/jats:p><jats:p>\n            Methods\u2003A meta-analysis was performed analyzing articles from Medline, Embase, and Pubmed. Four hundred and ninety-two articles were screened, and 134 articles were assessed for eligibility. Following full-text review, 43 articles were included in this study.<\/jats:p><jats:p>\n            Results\u2003The exact timing for free-flap reconstruction, free-flap failure rate, infection rate, and follow-up was defined in all 43 articles. Early free-flap reconstruction was found to have significantly lower rates of free-flap failure and infection in comparison to delayed reconstruction (p\u2009=\u20090.008; p\u2009=\u20090.0004). Compared with late reconstruction, early reconstruction was found to have significantly lower infection rates only (p\u2009=\u20090.01) with no difference in free-flap failures rates. Early reconstruction was found to lead to fewer additional procedures (p\u2009=\u20090.03). No statistical significance was found for bone healing time or hospitalization time.<\/jats:p><jats:p>\n            Conclusion\u2003Early free-flap reconstruction performed within the first 72 hours resulted in a decreased rate of free-flap failures, infection, and additional procedures with no difference in other parameters. The largest majority of free flaps continue to be performed in a delayed time frame.<\/jats:p>","DOI":"10.1055\/s-0037-1621724","type":"journal-article","created":{"date-parts":[[2018,2,3]],"date-time":"2018-02-03T05:23:37Z","timestamp":1517635417000},"page":"277-292","source":"Crossref","is-referenced-by-count":59,"title":["Meta-analysis of Timing for Microsurgical Free-Flap Reconstruction for Lower Limb Injury: Evaluation of the Godina Principles"],"prefix":"10.1055","volume":"34","author":[{"given":"M\u00e9lissa","family":"Roy","sequence":"first","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashit","family":"Patel","sequence":"first","affiliation":[{"name":"Division of Plastic Surgery, Albany Medical Centre, Albany, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siba","family":"Haykal","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, University of Toronto, Toronto, Ontario, Canada"},{"name":"Division of Plastic Surgery, Albany Medical Centre, Albany, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2018,2,2]]},"container-title":["Journal of Reconstructive Microsurgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0037-1621724.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2018,4,19]],"date-time":"2018-04-19T18:41:01Z","timestamp":1524163261000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0037-1621724"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,2,2]]},"references-count":0,"journal-issue":{"issue":"04","published-online":{"date-parts":[[2018,4,19]]},"published-print":{"date-parts":[[2018,5]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0037-1621724","relation":{},"ISSN":["0743-684X","1098-8947"],"issn-type":[{"value":"0743-684X","type":"print"},{"value":"1098-8947","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,2,2]]}}}