Outcomes of Radial Forearm Free Flap Reconstruction for Eyelid and Orbital Defects: A Systematic Review and Meta-Analysis
Author: Daniella Reyes
Base Hospital / Institution: Queen Mary University of London, UK
Abstract ID: 25-103
Purpose
The Radial Forearm Free Flap (RFFF) is frequently utilized in head and neck reconstruction and serves as a versatile option for restoring complex eyelid and orbital defects, particularly following orbital exenteration. This study examines the efficacy and complication rates of RFFF in these reconstructive procedures.
Methods
A comprehensive search of PubMed, Dynamed, DARE, EMBASE, Cochrane, and BMJ databases was conducted to identify studies evaluating RFFF in eyelid and orbital reconstruction (Registry: CRD42024584536). Data on patient demographics, surgical indications, and outcomes were systematically extracted and analyzed.
Results
A total of 22 studies met the eligibility criteria, reporting on 40 RFFF procedures performed in 40 patients (ages 21–93, male-to-female ratio 2.1:1). Of these, 65% (n=26) were used for orbital socket reconstruction, and 75.7% (n=28) followed tumor resection. The overall success rate was 92.8% (95% CI, 83.25–100, P = 0.39, I² = 5%), while complications occurred in 8.62% of cases (95% CI, 0–24.98%, P<0.01, I² = 78%). Flap failure was reported in 10% (n=4) of cases, with wound dehiscence being the most frequent complication (n=2).
Conclusion
RFFF achieves success rates and a complication profile similar to other commonly employed reconstructive flaps, including the anterolateral thigh, rectus abdominis, and latissimus dorsi flaps. Its ability to provide both functional and aesthetic restoration makes it a valuable choice, especially for cases requiring orbital exenteration reconstruction. When local flap options are not viable, RFFF remains a reliable alternative. However, further research and standardized reporting are necessary to optimize long-term outcomes and reduce donor-site morbidity.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Luke | Mattey | Cardiff University, Wales, United Kingdom |
| Umar | Rehman | UCL Division of Surgery and Interventional Sciences, University College London, London, United Kingdom |
| Shireen | Gohari | Department of Otolaryngology and Head and Neck, St. George’s Hospital, London, UK |
| Mohammad | Sarwar | Department of Oral and Maxillofacial Surgery, Bradford Royal Infirmary, Bradford, United Kingdom |
| Peter | Brennan | Department of Oral and Maxillofacial Surgery, Queen Alexandra Hospital, Portsmouth, United Kingdom |
