Reconstructive Surgery · ERAS
Do multidisciplinary ERAS protocols improve flap reconstruction outcomes? A structured review of efficacy, implementation challenges, and specialty-driven adaptations
This structured review finds that enhanced-recovery pathways in breast, head and neck, pelvic, and lower-limb flap reconstruction are generally associated with shorter hospital stays, earlier mobilization or feeding, and lower opioid exposure without a clear increase in flap compromise or reoperation. The authors emphasize tailoring bundles to flap type and auditing local outcomes rather than adopting a single universal protocol.
Head & Neck · Functional Reconstruction
Head and Neck Cancer Reconstruction with Flap: A Comparative Study of Restoration of Internal Lining VS No Restoration
In a 48-patient comparative study, adding internal lining restoration to flap-based head and neck reconstruction was associated with fewer infections, dehiscences, flap necrosis, and fistulas. The restoration group also had better swallowing, speech, oral-feeding, and overall functional outcomes, supporting preservation of mucosal lining when feasible.
Breast Reconstruction · Flap Selection
Comparison of Outcomes After Autologous Breast Reconstruction: Pedicled Extended Latissimus Dorsi Flap Versus Pedicled Transverse Rectus Abdominis Myocutaneous Flap
This prospective comparative study of 40 immediate breast reconstructions found similar recovery, hospital stay, mobilization, and QoR-15 trajectories for pedicled extended latissimus dorsi and pedicled TRAM flaps. Seroma was substantially more common with the extended latissimus dorsi approach, while overall short-term quality of recovery was comparable.
Microsurgery · Robotic Anastomosis
Effectiveness and safety of robotic microsurgery in free-flap reconstruction: A systematic review and single-arm meta-analysis
A systematic review of 13 clinical studies involving 264 patients reports 338 robotic anastomoses, a pooled flap-survival rate of 96%, and a mean anastomosis time of 39.1 minutes. The evidence supports feasibility in anatomically constrained fields, but comparative and long-term studies are still needed before robotic microsurgery can be positioned against conventional practice.
Diabetic Wounds · Nanotherapeutics
Combination therapy strategies for diabetic foot ulcers: synthesizing antibiotics, growth factors, and nanocarriers in modern wound management
This review maps combination strategies that pair antimicrobials, growth factors, and nanocarriers to address biofilm, inflammation, impaired angiogenesis, and oxidative stress in diabetic foot ulcers. Stimuli-responsive and sequential-release platforms are promising, but biosafety, manufacturing scale-up, regulatory approval, and long-term clinical validation remain major translational barriers.
Chronic Wounds · Photobiomodulation
Clinical dosimetry and efficacy of LED photobiomodulation for chronic lower-limb wound healing: a systematic review of randomized trials
A systematic review of six randomized trials suggests LED photobiomodulation may reduce wound area, improve wound-bed quality, and increase microcirculation, especially in diabetic foot ulcers. Evidence certainty was very low because wavelengths and doses varied widely, including a high-energy protocol with no apparent benefit; standardized dose-response trials are needed.
Diabetic Wounds · Negative Pressure Therapy
The Underlying Mechanisms and Role of Negative Pressure Wound Therapy in Chronic Diabetic Wound Healing: A Systematic Review and Meta-Analysis
Across 21 studies, negative-pressure wound therapy was associated with faster healing, a mean hospital stay reduction of 7.8 days, and fewer major or minor amputations compared with standard dressings. Mechanistic studies point to reduced inflammation and oxidative stress with improved angiogenesis, but small cohorts and inconsistent outcomes limit certainty.
Chronic Wounds · Plasma Therapy
Reactive Nitrogen–Dominant Plasma Accelerates Diabetic Wound Healing Through Regulated Angiogenesis and TGF-β Normalisation
In a diabetic-rat model, nitrogen-dominant nonthermal plasma reached 90% closure by day 19, compared with day 24 for argon plasma and more than 30 days for untreated controls. The response was linked to earlier, self-limited angiogenesis, improved collagen maturation, and normalization of TGF-β signaling, suggesting gas chemistry may shape plasma therapy outcomes.
Advanced Wound Care · CAMPs
Interim Analysis of the TIGERCAMP Trial Evaluating Cellular, Acellular, and Matrix-Like Products (CAMPS) in Diabetic Foot Ulcers
In this multicenter randomized platform trial, interim Bayesian estimates directionally favored a full-thickness placental membrane plus standard care over standard care alone for 12-week closure and wound-area reduction. The analysis is exploratory and interim, but it supports continued comparative evaluation of placental membranes within a standardized wound-care pathway.
Skin Substitutes · Policy and Access
Early reported effects of the 2026 CMS Physician Fee Schedule on patient access to CAMPs in wound care: a national clinician and practice survey
A national survey of 130 wound-care respondents found that 96% reported at least one operational impact after the 2026 unified CAMP payment took effect, with authorization delays the most common concern. More than 45% reported closure or planned closure of a service line, raising an access warning that is clinically relevant for advanced wound reconstruction and salvage pathways.
Acellular Dermal Matrix · Foot Reconstruction
Long-Term Clinical and Radiologic Evaluation of Micronized Acellular Dermal Matrix-Assisted Reconstruction in Diabetes-Related and Traumatic Foot Wounds With Bone Defects
Among 52 patients treated after bone or joint resection, 48 achieved complete epithelialization with a mean closure time of 5.6 weeks; delayed healing and mild infection were manageable without progressive osteomyelitis or graft loss. The matrix appears most useful for dead-space management, contour preservation, and durable coverage rather than as a bone substitute.
Fish Skin · Complex Wounds
Evaluation of Acellular Intact Fish Skin Grafts for Treating Acute and Chronic Wounds
In a retrospective series of 44 difficult-to-treat wounds, 88.6% showed size reduction and 45.45% reached complete closure after acellular Atlantic cod skin grafting. The treatment was well tolerated and included challenging presentations such as exposed bone and pyoderma gangrenosum, although prospective comparative evidence is still needed.
Exosomes · Diabetic Wounds
Therapeutic Application of hUC-MSC-derived Exosomes in Diabetic Wounds: A Scoping Review
This scoping review identified 19 studies, including two randomized clinical trials, on human umbilical-cord mesenchymal-stromal-cell exosomes for diabetic wounds. Across mostly preclinical work and a small clinical evidence base, exosomes were linked to angiogenesis, M2 macrophage polarization, matrix remodeling, and favorable safety; standardization and multicenter trials remain the key next steps.
Exosomes · Engineering and Translation
Adipose-derived stem cell exosomes: mechanisms and therapeutic potentials in wound healing
This review describes how adipose-derived stem-cell exosomes may coordinate inflammation, cell migration, angiogenesis, and collagen remodeling through cytokines, proteins, and non-coding RNAs. It highlights engineering and biomaterial-loading approaches that could improve potency and retention, while underscoring unresolved issues in scalable production, isolation standards, and clinical validation.
Energy-Based Devices · Laser and Light
Aesthetic Applications of Laser and Light-Based Energy Devices
This narrative review positions fractional, nonablative, picosecond, vascular, and hybrid laser platforms as complementary tools for resurfacing, vascular and pigmentary lesions, scar modulation, and drug delivery. It emphasizes individualized wavelength and parameter selection, phototype-aware risk management, and multimodal sequencing rather than a one-device-fits-all approach.
Postprocedure Care · Fractional CO₂ and RFMN
Efficacy and Safety of a Topical Skincare Regimen with Tripeptide/Hexapeptide following Aesthetic Procedures: Analysis of Two Randomized, Split-Face Trials in Asian Subjects
Two randomized split-face studies in Asian subjects found a peptide-based topical regimen generally matched or exceeded a basic moisturizer for early recovery after fractional CO₂ laser and radiofrequency microneedling. Improvements were most evident in transepidermal water loss, edema, redness, and tactile roughness, with few mild adverse events; larger controlled studies are still warranted.
Aesthetic Safety · Laser Complications
BC04 Laser device complications in facial aesthetics procedures: a MAUDE database study (2015–2025)
Analysis of 224 FDA MAUDE reports found burns accounted for 66% of reported patient problems after facial aesthetic laser procedures, followed by visual impairment, discoloration, pain, and scarring. Among burns with an identifiable cause, 40% involved device malfunction and 40% involved user or operator error, reinforcing the importance of counseling, maintenance, protocols, and training.
Aesthetic Dermatology · IPL
Clinical Application of Intense Pulsed Light: An Update and Critical Review
This critical review finds the strongest contemporary evidence for intense pulsed light in erythematotelangiectatic rosacea and meibomian-gland-dysfunction-related ocular surface disease, with emerging applications in rejuvenation, scars, dyschromia, and hair reduction. Device heterogeneity, parameter variation, and limited long-term comparative evidence argue for cautious, indication-specific protocols.
Fat Grafting · Breast Reconstruction
Efficacy and safety of fat grafting in breast reconstruction: A systematic review and meta-analyses of outcomes following mastectomy
A meta-analysis of 13 studies found nonenriched fat-graft retention varied from 26.0% to 74.8%, with a pooled mean of 47% and lower retention after excluding flap-augmented or water-jet techniques. Fat grafting improved patient-reported outcomes without a significant complication difference, but the high heterogeneity highlights the need for standardized volumetric assessment and technique-specific reporting.
Fat Grafting · Irradiated Breast
Florid inflammatory reaction after fat grafting into an irradiated DIEP-reconstructed breast mimicking cancer recurrence
This case report describes an intense inflammatory reaction with indurated erythematous nodules after fat grafting into a previously irradiated DIEP-reconstructed breast, clinically mimicking recurrence. The lesions resolved conservatively, but the authors stress imaging and biopsy of suspicious findings because radiation-damaged tissue can produce unusual post-grafting reactions.
Fat Grafting · Orbital Contour
Application of Autologous Fat Grafting Combined With Orbital Fat Flap Transposition for the Correction of Mild to Moderate Upper Eyelid Hollowing in Double Eyelid Surgery: A 3-Arm Retrospective Controlled Study
In 135 patients, combining orbital-fat-flap transposition with autologous fat grafting produced greater and more durable upper-eyelid hollowing correction than flap transposition alone or the combination with hyaluronic acid. The fat-grafting combination also had the highest satisfaction scores, supporting a layered approach for selected mild-to-moderate defects.
Autologous Grafts · Mandibular Reconstruction
Comparative Analysis of Postoperative Complications Following Autologous Free Dermal Fat Grafting in Free Fibula Reconstructed Mandibular Gingivobuccal Complex SCC: A Retrospective Cohort Study
Among 105 patients undergoing fibula-flap reconstruction, concurrent free dermal-fat grafting was associated with lower plate exposure and chronic pain and achieved 60.9%–73.9% thickness retention at six months. Early quality-of-life scores favored the grafting group, although differences narrowed by nine months and the retrospective design limits causal inference.
AI · Plastic Surgery Research
Artificial Intelligence in Plastic Surgery: A Bibliometric and Visual Analysis of the 100 Most-Cited English-Language Publications
A bibliometric analysis of the 100 most-cited English-language AI papers in plastic surgery found a sharp post-2022 publication surge, with patient education and large-language-model consultation the largest thematic cluster. Ethical and governance issues accounted for 17% of themes, while outcome prediction and risk modeling remained comparatively underrepresented, helping define the field’s current research gaps.
AI and Robotics · Microsurgery
Factors Influencing Acceptance of AI-Assisted Robotic Surgery: Review of Patient and Surgeon Perspectives
This scoping review of only three sources suggests trust in AI-assisted robotic surgery is strongest when systems remain decision-support tools rather than autonomous operators. Both patients and surgeons may overestimate autonomy, indicating that transparent communication, education, and preserved surgeon control will be central to adoption; the evidence remains hypothesis-generating because of the small literature base.
Robotics · Reconstructive Surgery
Smart hands: robotic systems as surgical collaborators in plastic and reconstructive surgery
This review describes how motion scaling and tremor suppression are bringing open-field robotic microsurgery into clinical practice, while AI and augmented reality support perforator mapping, flap selection, complication prediction, navigation, and training. The authors frame robotics as an augmentation layer rather than a replacement for surgeon expertise, with data quality, bias, interoperability, and regulation as the main implementation constraints.
AI · 3D Planning
Recent advances and future directions in AI and robotics in plastic reconstructive breast surgery including 3D imaging
This review highlights AI-supported vascular visualization, 3D surface rendering, printed anatomical models, and robotic systems as emerging tools across preoperative planning, intraoperative problem-solving, and postoperative assessment in breast reconstruction. The direction of travel is toward integrated 3D and AI workflows that make perforator mapping and patient-specific planning more actionable.