title: Early Postoperative Complications following Gracilis Free Muscle Transfer for Facial Reanimation: A Systematic Review and Pooled Data Analysis.
abstract: BACKGROUND
  Multiple studies have detailed promising smile restoration following gracilis free muscle transfer for facial reanimation but information detailing the potential complications is lacking. The aim of this study is to systematically review the literature to evaluate the reported complication rate associated with this procedure. We also aim to determine the most common occurring complications.
  
  
  METHODS
  The PubMed, Embase, and Web of Science databases were queried with multiple search strategies for published articles between January 1950 and February 2013 that detailed gracilis free muscle transfer for facial reanimation. Title, abstract, and full text review was performed. Complications were defined as any reported, identifiable adverse outcome that required an alteration in treatment for correction.
  
  
  RESULTS
  The literature search yielded 62 studies of gracilis free muscle transfer for facial reanimation. Overall, 36 articles (58%) reported whether or not a complication had occurred. The overall complication rate based on pooled proportions was 9.6% and the most commonly occurring complications were postoperative hematoma (3.6%) and infection (3.5%).
  
  
  CONCLUSIONS
  Our data suggests that complications after gracilis free muscle transfer for facial reanimation may be underreported and this complex procedure may in fact be associated with significant adverse outcomes as high as 9.6%.
authors.affiliation: Division of Plastic, Reconstructive, Oral, Maxillofacial Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina.
authors.forename: Ryan M
authors.initials: RM
authors.lastname: Garcia
authors.affiliation: Department of Plastic and Reconstructive Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Arun K
authors.initials: AK
authors.lastname: Gosain
authors.affiliation: Division of Plastic, Reconstructive, Oral, Maxillofacial Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Zenn
authors.affiliation: Division of Plastic, Reconstructive, Oral, Maxillofacial Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina.
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Marcus
mesh_terms: D016208:Databases, Factual; D005149:Facial Expression; D005151:Facial Injuries / Q000601:surgery; D005158:Facial Paralysis / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D058752:Free Tissue Flaps / Q000009:adverse effects* / Q000637:transplantation; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000009:adverse effects* / Q000379:methods; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology; D052097:Quadriceps Muscle / Q000637:transplantation*; D020127:Recovery of Function; D018570:Risk Assessment; D012904:Smiling / Q000502:physiology*; D013997:Time Factors; D016896:Treatment Outcome