Microsurgery · Supermicrosurgery
The Application of Supermicrosurgery in Lower Extremity Reconstruction and Future Implications
This review frames supermicrosurgery as work on vessels <0.8 mm, enabling perforator-to-perforator anastomoses, minimally invasive reconstructions, and lymphatic procedures. It highlights enabling technologies—ultrafine instruments, enhanced imaging, exoscopes, and emerging robotic platforms—as key drivers of broader adoption.
Free Flaps · Vascular Planning
Recipient vessel selection in autologous breast reconstruction: a narrative review of strategies and clinical implications
This narrative review synthesizes decision-making for recipient vessel choice in free-flap breast reconstruction. Internal mammary vessels remain first-line, while internal mammary perforators are explored for reduced morbidity but with reliability tradeoffs; thoracodorsal/axillary options remain useful second-line pathways.
Microsurgery · Complication Management
Aneurysmal Veins in Free Flaps: A Rare Case Report and Discussion
This case report describes unexpected aneurysmal veins encountered during free-flap reconstruction and the intraoperative technical challenges they created for microvascular anastomosis. The discussion emphasizes anticipating aberrant venous anatomy, troubleshooting vessel quality issues, and having salvage strategies ready to reduce thrombosis-related flap risk.
Robotics · DIEP Flap
Comparison of Robotic-assisted and Conventional Deep Inferior Epigastric Perforator Flaps: A Retrospective Cohort Study
In a cohort of 68 DIEP reconstructions, robotic-assisted perforator-to-perforator anastomoses showed similar complication rates and length of stay versus conventional approaches. Notably, the perforator-to-perforator robotic group required significantly less postoperative opioid-equivalent analgesia, suggesting a potential recovery benefit without apparent early safety tradeoffs.
Adjunctive Therapy · Topical Oxygen
Clinical Efficacy and Safety of Portable Continuous Topical Oxygen Therapy for Chronic Wound Management: A Randomised Controlled Trial
This randomized trial compared portable continuous topical oxygen therapy (CDO) vs moist wound therapy in 88 chronic-wound patients. Oxygen therapy accelerated early healing metrics (area/depth reduction and pH improvement) and shortened time-to-heal, with no oxygen-related adverse events reported.
Digital Health · AI Decision Support
Artificial Intelligence-Assisted Clinical Decision Support System in Telemedical Wound Care: A Randomized Controlled Trial
In a 40-patient randomized trial, an AI-enabled telemedicine platform that auto-measured wound size, classified tissues, and flagged deterioration was noninferior to conventional care for 12-week healing outcomes. It reduced required clinic visits and improved caregiver quality-of-life measures, supporting AI-assisted remote monitoring as a utilization-reducing adjunct.
Adjunct Dressing · PRP
Platelet Rich Plasma Dressing Versus Normal Saline Dressing in the Management of Chronic Diabetic Wounds
This randomized trial in 156 patients with diabetic ulcers found higher complete healing rates and faster healing with PRP dressings versus normal saline dressings, alongside fewer post-treatment infections. The results reinforce PRP as a high-yield adjunct when access and protocol standardization are feasible.
Best Practice · Debridement
Continuous integral debridement: optimising wound bed preparation through the cleanse, debride, cleanse and dress cycle
An expert panel proposes “continuous integral debridement” as a practical, repeatable cycle (cleanse–debride–cleanse–dress) intended for routine settings. The guidance positions CID as compatible with TIME/TIMERS frameworks and antibiofilm strategies, emphasizing repeated disruption of barriers to healing across the wound’s course.
Breast Reconstruction · ADM Safety
The Use of Acellular Dermal Matrix May Not Increase 30-Day Complications in Direct-to-Implant Breast Reconstruction: A Multi-institutional Analysis of 10,177 Cases
Using NSQIP data from 10,177 direct-to-implant reconstructions, this analysis found no increased odds of short-term surgical or medical complications with ADM use after adjustment and propensity matching. The results support ADM as a viable option when selected for support/positioning benefits, while still weighing cost and longer-term risks.
Facial Reconstruction · Exposed Cartilage
Single-stage acellular dermal matrix reconstruction of defects in the nose and ears with exposed cartilage: a prospective case series
This prospective series reports single-stage ADM coverage for nasal/auricular defects with exposed cartilage, aiming to avoid scarring and secondary procedures associated with local flaps. Patients healed in ~3 weeks on average and reported high satisfaction, suggesting ADM can be a streamlined option in carefully selected cartilage-exposed defects.
Breast Reconstruction · Technique Comparison
Prepectoral Breast Reconstruction: Early and Long-Term Complications and Outcomes of Total Coverage Acellular Dermal Matrix and Implants Vs Polyurethane-Coated Implants Without Use of Acellular Dermal Matrix
In a retrospective cohort of 97 patients, polyurethane-coated implants (without ADM) showed lower early seroma/infection rates and lower 5-year severe capsular contracture compared with ADM-covered textured implants. Findings suggest PU implants may offer a lower-complication pathway for selected prepectoral reconstructions, especially where contracture risk is a priority.
Biomaterials · ADM Alternatives
Engineered silk matrix as a substitute for acellular dermal matrix in breast reconstruction surgery
This biomaterials study proposes an engineered silk fibroin matrix designed to improve cellular adhesion and tissue integration while reducing ADM-associated risks (e.g., seroma, infection concerns). In vitro and porcine in vivo data showed enhanced fibroblast density, collagen deposition, and vascularization versus collagen matrices, supporting further translational evaluation as an ADM alternative.
Exosomes · Hydrogel Dressings
A Dual-Dynamic Crosslinked Polysaccharide-Based Hydrogel Loaded with Exosomes for Promoting Diabetic Wound Healing
This study describes an ROS-responsive, self-healing hydrogel incorporating MSC-derived exosomes to modulate inflammation in diabetic wounds. In a mouse diabetic-wound model, the exosome-loaded hydrogel promoted macrophage M2 polarization and increased cellular proliferation, accelerating wound closure.
Biofilm + Regeneration · Multifunctional Hydrogel
Self-healing quaternized chitosan-phenylboronic hydrogel with ceria nanozymes and stem-cell exosomes simultaneously eradicates MRSA biofilm and regenerates diabetic wounds
A multifunctional injectable hydrogel combined intrinsic antibacterial components, ceria nanozyme antioxidant activity, and embryonic stem cell exosomes. In MRSA-infected diabetic wounds in mice, the platform cleared biofilm, reduced oxidative stress, and achieved near-complete closure within 12 days while increasing collagen deposition.
Guidelines · Antimicrobial Stewardship
International guideline on antimicrobial stewardship and the role of microbial-binding dressings in wound care 2026: infection prevention, control, early intervention and treatment
This 2026 guideline addresses wound infection prevention and antimicrobial stewardship, emphasizing early identification and non-antibiotic strategies to reduce antimicrobial overuse. It highlights microbial-binding dressings as a first-line infection-prevention/control approach and provides practical clinical pathways for implementation.
Exosomes · Skin Regeneration Review
Stem Cell-Derived and Plant-Derived Exosomes: Promising Therapeutics for Skin Healing and Regeneration
This systematic review outlines mechanisms by which stem- and plant-derived exosomes may support cutaneous repair (immunomodulation, angiogenesis, collagen remodeling). It also frames exosome-based approaches as a bridge between wound care and aesthetic rejuvenation, while underscoring the need for standardized manufacturing and stronger clinical evidence.
Energy Devices · Helium Plasma RF
Helium Plasma Radiofrequency for Aesthetic Subdermal Treatment: A Systematic Review and Meta-analysis
This systematic review/meta-analysis pooled 34 studies (3,508 patients) on helium plasma RF for subdermal skin laxity (standalone or adjunct to liposuction). Reported complication rates were low across use-cases and pooled patient satisfaction was high, but the review underscores heterogeneous study designs and outcome measures across the literature.
Device Safety · Challenging Skin
Dual-mode Sequential Radiofrequency in Challenging Skin Types: Case Reports in Atopic-prone and Previously Treated Patients
Two case reports describe use of a dual-mode monopolar–bipolar RF system with contact cooling in atopic-prone skin and previously treated skin. Both patients saw tightening and texture improvements without flares/major adverse events, suggesting potential as a maintenance or adjunct modality in carefully counseled patients.
RF Microneedling · Surgical Planning
Navigating the Intersection of Radiofrequency Microneedling and Surgical Facelifts: Scoping Review
This scoping review evaluates how radiofrequency microneedling can alter tissue planes relevant to later facelift surgery. The authors highlight risks of dermal fibrosis and adhesions that may complicate future dissection, emphasizing the need to counsel patients on procedure sequencing and long-term planning.
RF Devices · Trial Evidence
Efficacy and safety of a novel monopolar radiofrequency device for skin tightening: a multicenter, randomized, 6-month, assessor blind, positive parallel-controlled, non-inferiority trial
This multicenter randomized noninferiority trial evaluates a new monopolar RF device for skin tightening with blinded assessment over six months. While the abstract details are limited here, the trial design signals a push toward higher-quality comparative evidence for energy-based tightening platforms beyond case series.
Breast Reconstruction · Safety + Satisfaction
Efficacy and safety of fat grafting in breast reconstruction: A systematic review and meta-analyses of outcomes following mastectomy
This systematic review/meta-analysis found autologous fat grafting to be a safe adjunct after mastectomy, with moderate pooled retention and no significant differences across major complication categories. Patient-reported outcomes consistently favored fat grafting, supporting its role for contour optimization and tissue-quality improvement.
Breast Fat Grafting · Technique Trial
Clinical Outcomes Following Autologous Fat Grafting for Breast Reconstruction: An Interim Analysis From a Randomized Controlled Trial Comparing Lipoaspirate Processing Techniques
In this randomized trial of three processing methods (active wash/filtration, low-pressure decantation, and active wash with surfactant), early 3-month volume retention was similar across groups. The interim findings suggest multiple processing workflows may achieve comparable short-term retention, potentially allowing technique selection based on workflow, cost, and handling preferences.
Soft Tissue Reconstruction · Engineered Autologous Fat
A Scaffold-Free, Collagen-Guided Self-Assembling Adipose Construct for Functional Soft Tissue Reconstruction
This translational study introduces a collagen-guided “self-assembly fat” construct created from lipoaspirate, aiming to improve structural stability and vascularization compared with standard fat grafting. In vivo data suggest enhanced angiogenesis and a pro-regenerative immune microenvironment, supporting a potential future pathway for larger-volume soft-tissue reconstruction.
Fat Grafting Outcomes · Network Meta-analysis
Comparative Efficacy and Safety of Different Assisted-fat Transplantation Methods: A Network Meta-analysis of Randomized Controlled Trials
This network meta-analysis of 47 RCTs compared adjuncts to fat transplantation and found that not all supplements improve retention. Stem cell-, PRP-, and SVF-assisted approaches showed meaningful retention improvements, while complication and satisfaction profiles varied across methods.
Robotics + AI · Breast Reconstruction
Recent advances and future directions in AI and robotics in plastic reconstructive breast surgery including 3D imaging
This review maps how AI-enabled 3D imaging, perforator mapping, and 3D-printed models are being integrated into microsurgical breast reconstruction workflows. It also outlines where robotic platforms may augment microsurgical tasks, emphasizing the trajectory toward data-informed planning and intraoperative problem-solving.
Robotics · Microsurgery Evidence
Effectiveness and safety of robotic microsurgery in free-flap reconstruction: A systematic review and single-arm meta-analysis
Across 13 clinical studies (264 patients), this meta-analysis reports high pooled flap survival and feasible anastomosis times for robot-assisted microsurgery, predominantly using the Symani system. It supports clinical feasibility in constrained operative fields while underscoring the need for comparative trials and long-term outcome data.
Robotics · Extremity Orthoplastic
The application of robot-assisted microsurgery in orthoplastic surgery
This prospective institutional series describes robot-assisted free-flap reconstruction for complex extremity trauma within an orthoplastic model. The authors report feasibility without conversions and low major-complication burden, suggesting robot-assisted microsurgery may be a practical next step in demanding limb salvage settings.
AI/Robotics/AR · Systems View
Smart hands: robotic systems as surgical collaborators in plastic and reconstructive surgery
This overview positions next-generation microsurgery robots (e.g., Symani, MUSA) alongside AI planning, complication prediction, and AR navigation as a converging ecosystem. It highlights expected benefits (precision, ergonomics, reproducibility) and key barriers including data quality, bias, interoperability, and regulatory clarity.