Safety and Efficacy of the Superior Gluteal Artery Perforator (SGAP) Flap In Autologous Breast Reconstruction: Systematic Review and Metanalysis

Abstract

Introduction: The superior gluteal artery perforator (SGAP) flap is a valuable technique for autologous breast reconstruction and provides a good alternative to the deep inferior epigastric artery perforator (DIEP) flap, especially in patients with unsuitable lower abdominal tissue. Unlike more commonly used techniques current literature on the outcomes and complications of the SGAP flap is relatively heterogenous and limited. Materials and Methods: A systematic literature search of multiple databases was performed by two independent reviewers using the PRISMA guidelines. We included articles evaluating SGAP flaps in autologous breast reconstruction. Patient’s and flap-related data, flap-related outcomes and complications and donor-site morbidity were recorded and analyzed. Proportions and their 95% confidence intervals (CIs) were calculated in a random-effects meta-analysis. Results: Fifteen studies meeting the inclusion criteria representing a total of 673 SGAP flaps were included. Total flap loss rate was 2% (95% CI 1), partial flap loss rate was 3% (95% CI 0), hematoma rate was 5% (95% CI 2), emergent operative take-back was 7% (95% CI 7) and overall donor-site complications was 12% (95% CI 4). Conclusion: This study is the first systematic review evaluating the efficacy and safety of the SGAP flap in autologous breast reconstruction. It confirms the overall safety and low complication rate of the SGAP flap in breast reconstruction.