Sensory restoration following breast reconstruction with operative reinnervation: A systematic review and meta-analysis

• Published in: Journal of plastic, reconstructive & aesthetic surgery reconstructive & aesthetic surgery, 2024-10
• Main Authors: Ghumman, Ammara, Kim, Patrick J., McAlpine, Kristen, Meng, Fanyi, Snell, Laura, Lipa, Joan
• Format: Article
• Language: English
• Subjects: Breast reconstruction; Mammoplasty; Neurotization; Sensation
• ISSN: 1748-6815; 1878-0539; 1878-0539
• DOI: 10.1016/j.bjps.2024.10.021

There is currently no consensus on the efficacy of operative reinnervation at the time of post-mastectomy reconstruction. This review compares postoperative sensation between innervated and non-innervated flaps in breast reconstruction through systematic review and meta-analysis. EMBASE, Ovid, and CENTRAL were searched from inception to December 6, 2023. The primary outcome was level of sensation postoperatively. Secondary outcomes included presence of sensation, breast-related complications, operative time, and quality of life. Meta-analysis was conducted using mean difference (MD) or standardized mean difference (SMD) for continuous outcomes and odds radio (OR) for dichotomous outcomes. Quality of evidence was appraised using RoB-2/ROBINS-I. Certainty of evidence was assessed with Grading of Recommendations, Assessment, Development and Evaluations. Twenty-eight studies were included; studies were observational studies except one randomized controlled trial. Common flaps were deep inferior epigastric perforator (11/28, 39.3%) and transversus rectus abdominis muscle (9/28, 32.1%). Innervated flaps were significantly associated with improved level of postoperative sensation (SMD: −0.94, 95% CI: [−1.35; −0.53], I2: 78%, p