Evidence map›Paper›PMID 42423831›Full record

SynthesisHernia : the journal of hernias and abdominal wall surgery2026

Clinical outcomes in abdominal wall autologous flap reconstruction: a systematic review.

Michalis Hadjiandreou, Sola Kim, Cheuk Ying Kyleen Kiew, Bijendra Patel, Parviz Lionel Sadigh, Gurjinderpal Singh Pahal, David Ross, Georgios Pafitanis

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Hernia : the journal of hernias and abdominal wall surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Michalis HadjiandreouDepartment of Plastic and Reconstructive Surgery, Microsurgery Unit, The Royal London Hospital, Barts Health NHS Trust, London, UK. hadjiandreoumichalis@gmail.com.ORCID http://orcid.org/0000-0002-2535-7896
Sola KimThe London School of Medicine and Dentistry, Barts Cancer Institute, Queen Mary's University of London, Barts, UK.
Cheuk Ying Kyleen KiewDepartment of Medicine, Imperial College London, Ayrton Rd, South Kensington, London, SW7 5NH, UK.
Bijendra PatelDepartment of General Surgery, Barts Cancer Institute & The Royal London Hospital, Barts Health NHS Trust, London, UK.
Parviz Lionel SadighDepartment of Plastic and Reconstructive Surgery, Microsurgery Unit, The Royal London Hospital, Barts Health NHS Trust, London, UK.
Gurjinderpal Singh PahalDepartment of Plastic and Reconstructive Surgery, Microsurgery Unit, The Royal London Hospital, Barts Health NHS Trust, London, UK.
David RossGuys' and St Thomas' Hospital NHS Trust and Kings College Hospital, London, England.
Georgios PafitanisDepartment of Plastic and Reconstructive Surgery, Microsurgery Unit, The Royal London Hospital, Barts Health NHS Trust, London, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeComplex abdominal wall defects present major reconstructive challenges when restoration of fascial continuity must be combined with durable soft-tissuecoverage, visceral protection, and, in selected cases, functional repair. Although autologous flap reconstruction is well established for selected indications, its overall role across defect types has yet to be established.

methodsA systematic review was performed in accordance with PRISMA guidelines (PROSPERO: CRD42023491916). PubMed/MEDLINE, Embase, Scopus, Web of Science, Cochrane Library, and Google Scholar were searched from inception to April 2026 for studies reporting adult autologous flap-based abdominal wall reconstruction. Given substantial clinical and methodological heterogeneity, data were analysed descriptively.

results172 studies comprising 4,421 patients were included. Pedicled flaps predominated (n=4,095, 92.6%), with free flaps used in 146 patients (3.3%) and mixed approaches in 180 (4.1%). Hernia-related pathology was the commonest indication (n=3751, 84.8%), followed by malignancy (n=470, 10.6%). Frequently used flap categories included anterolateral thigh, tensor fascia lata, rectus-based, and latissimus dorsi-based flaps. Flap selection was primarily defect-driven: fascia-bearing regional and turnover techniques were used mainly for structurally focused hernia repair, whereas composite flaps were used more often for oncologic, fistulating, traumatic, contaminated, or full-thickness defects. Common short-term complications include seroma, surgical site infection, and wound dehiscence. Flap failure and reported long term hernia recurrence were low. Free flaps were used more often for larger defects weighted mean 401 cm² vs 250 cm² for pedicled flaps), although size ranges overlapped.

conclusionsAutologous flap reconstruction is a durable and versatile option for selected complex abdominal wall defects. Reconstructive strategy should be guided primarily by defect composition.

Indexed as

Abdominal WallPlastic Surgery ProceduresSurgical FlapsFree Tissue FlapsHumansPostoperative ComplicationsTransplantation, AutologousAutologousComplex abdominal wall defectsComposite flapFree flapMicrosurgeryReconstruction

Identifiers

PMID42423831

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.