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Foppiani et al. Plast Aesthet Res 2023;10:53 Plastic and
DOI: 10.20517/2347-9264.2022.137
Aesthetic Research

Meta-Analysis Open Access

Comparing microsurgical breast reconstruction
outcomes following postoperative monitoring

techniques: a systematic review and meta-analysis
of 2529 patients

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Jose A. Foppiani , Lauren Valentine , Angelica Hernandez Alvarez , Allan Weidman , Stephen Stearns ,
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Lacey Foster , Karthika Devi , Khaled Albakri , Samuel J. Lin 1
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Division of Plastic Surgery, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA 02215, USA.
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Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA.
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Sri Manakula Vinayagar Medical College and Hospital, Puducherry, TN 605107, India.
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Faculty of Medicine, The Hashemite University, Zarqa 13133, Jordan.
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Authors considered joint first authors.
Correspondence to: Dr. Samuel J. Lin, Division of Plastic Surgery, Beth Israel Deaconess Medical Center/Harvard Medical
School, 110 Francis Street Suite 5A, Boston, MA 02215, USA. E-mail: sjlin@bidmc.harvard.edu
How to cite this article: Foppiani JA, Valentine L, Hernandez Alvarez A, Weidman A, Stearns S, Foster L, Devi K, Albakri K, Lin SJ.
Comparing microsurgical breast reconstruction outcomes following postoperative monitoring techniques: a systematic review
and meta-analysis of 2529 patients. Plast Aesthet Res 2023;10:53. https://dx.doi.org/10.20517/2347-9264.2022.137
Received: 30 Nov 2022 First Decision: 8 Aug 2023 Revised: 21 Aug 2023 Accepted: 4 Sep 2023 Published: 18 Sep 2023
Academic Editors: Gordon Kwanlyp Lee, Raffaele Rauso Copy Editor: Dan Zhang Production Editor: Dan Zhang
Abstract
Aims: This paper aims to assess the existing evidence regarding oximetry and thermography by comparing
postoperative rates of complications following microsurgical breast reconstruction.

Methods: A systematic review of PubMed, Web of Science, and Cochrane was completed. A qualitative and
quantitative analysis of all included studies was then performed.

Results: Fourteen studies were included with a total population of 2,529 female patients who underwent
microvascular breast reconstruction, ultimately totaling 3,289 flaps. The mean age for the cohorts included in this
study ranged from 48.9 to 57 years of age. A total of 15 complete flap losses were reported. Furthermore, this
meta-analysis of proportion showed that total flap loss experienced was 0% (95%CI 0%-100%) for patients
monitored with thermography compared to 0% (95%CI 0%-1%) for those monitored with oximetry. Partial flap
loss occurred at a frequency of 1% [95% confidence interval (CI) 0%-73%] for patients monitored with

© The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and
indicate if changes were made.

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