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January 22, 2026Journal of Clinical MedicineOpen Access

Complications of Free Flap Reconstruction in Maxillary and Mandibular Defects: A Systematic Review and Meta-Analysis

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Authors

FMFabio MaglittoSTStefania TroiseFCFederica Calabrìa

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Overview

Systematic review quantifies postoperative complications in free flap reconstruction, suggesting a need for standardized reporting.

Key Points

  • This review aims to quantify postoperative complications and evaluate patterns related to osseous free flap type in head and neck reconstruction.
  • Systematic review and meta-analysis of studies published from January 2000 to November 2025.
  • Included studies reporting complications post-mandibular or maxillary reconstruction with osseous free flaps.
  • Data pooled using random-effects meta-analyses of proportions, with risk of bias assessed using the ROBINS-I tool.
  • Pooled incidence of total flap loss was 6%, and partial flap loss was also 6%.
  • Infection rate was 7%, fistula formation 12%, and wound dehiscence 16%, indicating considerable variability.
  • Fibular flaps showed a total flap loss rate of 6.1% and wound dehiscence rates of 17.1%.
  • Scapular flaps had a total flap loss of 5%, while DCIA flaps had specific complications like wound dehiscence at 29.7%.

Cite This Study

Maglitto et al. (2026) studied this question.

synapsesocial.com/papers/6971bdcf642b1836717e27f3https://doi.org/10.3390/jcm15020797
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Incidence and Risk Factors for Free Flap Compromise in Head and Neck Reconstruction: A Meta‐Analysis2026
  2. 2Outcomes of Free Flap Bony Reconstruction for Maxillary Defects: A Systematic Review and Meta‐Analysis2025 · 3 citations
  3. 3Free Flap Versus Pedicled Flap for Oral Cavity Reconstruction: A Systematic Review and Meta-Analysis of Clinical Outcomes and Complications2026
  4. 4Complication drivers in head and neck free flap surgery: A single-center predictive analysis2026
  5. 5Clinical outcomes of fibular and scapular free osseous flaps in head and neck reconstruction: a retrospective comparative study2026