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Background <p>With little donor-site morbidity, adipofascial flaps have become a flexible reconstructive choice, providing thin, flexible, well-vascularized tissue. For both cosmetic improvement and functional restoration, they are being utilized more across several anatomical areas.</p> <p>This systematic review aims to comprehensively analyze the clinical indications, surgical techniques, outcomes, and complications of adipofascial flaps across all anatomical regions.</p> Methods <p>A systematic search was conducted in PubMed, Google Scholar, and the Cochrane Library from database inception to August 2025, following PRISMA 2020 guidelines. Studies were included if they reported clinical outcomes of adipofascial flaps in human reconstructive surgery with at least three patients. Case reports, reviews, experimental or animal studies, and non-English articles were excluded. The primary outcomes were flap survival, complications, donor-site morbidity, and functional or aesthetic results.</p> Results <p>Thirty-two studies involving a total of 951 patients and 951 adipofascial flaps were included. Overall flap survival exceeded 95% across all anatomical regions. Hand and fingertip reconstructions maintained protective sensation and motion in most patients, with static two-point discrimination ranging from 3.8 to 6.3 mm. In lower-limb reconstructions, adipofascial flaps provided superior contour, reduced bulk, and early return to ambulation compared with muscle or fasciocutaneous flaps. Donor-site complications occurred in less than 5% of cases and were generally minor, including partial necrosis, venous congestion, or cold intolerance.</p> Conclusions <p>For complex soft-tissue restoration, adipofascial flaps provide a dependable, flexible, and aesthetically pleasing option. They are an indispensable part of the current reconstructive ladder because of their predictable vascularity, functional advantages, and low donor-site morbidity. To better understand their ideal function and increase their evidence-based applications, future prospective trials employing standardized outcome measures are necessary. </p> <p><b>Level of Evidence</b>: Not ratable</p>

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From fingertips to lower limbs: a systematic review of adipofascial flaps across anatomical regions

  • 期刊论文

  • 发表日期：

    2025年12月6日

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  • Gabriele Delia,
  • Michele Rosario Colonna,
  • Marco Marcasciano,
  • Emanuele Cigna,
  • Michele Maruccia,
  • Fabiana Battaglia

摘要

Background

With little donor-site morbidity, adipofascial flaps have become a flexible reconstructive choice, providing thin, flexible, well-vascularized tissue. For both cosmetic improvement and functional restoration, they are being utilized more across several anatomical areas.

This systematic review aims to comprehensively analyze the clinical indications, surgical techniques, outcomes, and complications of adipofascial flaps across all anatomical regions.

Methods

A systematic search was conducted in PubMed, Google Scholar, and the Cochrane Library from database inception to August 2025, following PRISMA 2020 guidelines. Studies were included if they reported clinical outcomes of adipofascial flaps in human reconstructive surgery with at least three patients. Case reports, reviews, experimental or animal studies, and non-English articles were excluded. The primary outcomes were flap survival, complications, donor-site morbidity, and functional or aesthetic results.

Results

Thirty-two studies involving a total of 951 patients and 951 adipofascial flaps were included. Overall flap survival exceeded 95% across all anatomical regions. Hand and fingertip reconstructions maintained protective sensation and motion in most patients, with static two-point discrimination ranging from 3.8 to 6.3 mm. In lower-limb reconstructions, adipofascial flaps provided superior contour, reduced bulk, and early return to ambulation compared with muscle or fasciocutaneous flaps. Donor-site complications occurred in less than 5% of cases and were generally minor, including partial necrosis, venous congestion, or cold intolerance.

Conclusions

For complex soft-tissue restoration, adipofascial flaps provide a dependable, flexible, and aesthetically pleasing option. They are an indispensable part of the current reconstructive ladder because of their predictable vascularity, functional advantages, and low donor-site morbidity. To better understand their ideal function and increase their evidence-based applications, future prospective trials employing standardized outcome measures are necessary.

Level of Evidence: Not ratable