Evidence map›Paper›PMID 42525259›Full record

ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2026

Postoperative wound complications and revisions in high-risk patients undergoing spine surgery with prophylactic muscle flap reconstruction: systematic review and meta-analysis.

Alison Reilly, Asimina Dominari, Nadir Al-Saidi, Dina Mohammed, Charbel Moussalem, Mohamad Bydon

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Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Alison ReillyDepartment of Neurological Surgery, University of Chicago, Chicago, USA.
Asimina DominariDepartment of Neurologic Surgery, Mayo Clinic, Rochester, USA.
Nadir Al-SaidiDepartment of Neurological Surgery, University of Chicago, Chicago, USA.
Dina MohammedDepartment of Neurological Surgery, University of Chicago, Chicago, USA.
Charbel MoussalemDepartment of Neurologic Surgery, Mayo Clinic, Rochester, USA.
Mohamad BydonDepartment of Neurological Surgery, University of Chicago, Chicago, USA. Mohamad.Bydon@bsd.uchicago.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeProphylactic muscle flap reconstruction (PMFR) has been explored as a preventative closure technique for patients undergoing spine surgery who are at increased risk of developing surgical site infection (SSI) and other wound-related complications. This study evaluates how PMFR may mitigate complication and revision rates in these patients.

methodsA systematic literature search across Cochrane Central Register of Controlled Trials (Central), Embase, Medline, Scopus, and Web of Science was conducted from inception through July 2024 to identify all comparative studies utilizing PMFR for closure after spine surgery. Random-effects model meta-analysis was performed assessing wound complications and revisions required, and the Newcastle-Ottawa Quality Assessment Scale for observational studies was used to assess the quality.

resultsSix studies (n = 1,475) comparing PMFR to conventional closure were included in this study. Of which, 515 patients underwent PMFR, while 960 patients did not undergo PMFR. The mean age at surgery was 59.4 ± 15.3 in the PMFR group and 60 ± 18.6 in the non-PMFR group. The mean operative time (MD: -95.06, 95%CI -178.08 to -12.04, p = 0.02) and the mean length of stay (MD: -3.06, 95%CI -4.99 to -1.14, p < 0.01) were significantly shorter in the non-PMFR group compared to the PMFR group. Neither SSI (OR 0.72, 95%CI 0.31 to 1.67, p = 0.36) nor wound dehiscence (OR 0.54, 95%CI 0.06 to 4.96, p = 0.35) were significantly different between the PMFR and non-PMFR groups. Revisions due to wound complications (OR 0.85, 95%CI: 0.24 to 2.95, p = 0.73) and overall revisions (OR 1.68, 95%CI: 0.64 to 4.38, p = 0.23) did not significantly differ between groups.

conclusionThis meta-analysis of six studies did not show any significant differences in perioperative wound complication or revision rates among patients who underwent spine surgery with or without PMFR, despite patients in the PMFR presenting with significantly more risks for wound complications. Given the increased operative time and length of stay associated with the PMFR group, PMFR should be selectively implemented based on individual patient risk profiles.

Indexed as

High-risk closureProphylactic muscle flap reconstructionSoft tissue reconstructionSpine surgerySurgical site infection (SSI)Wound complications

Identifiers

PMID42525259

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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.