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 recommend adapting bundles to flap type, comorbidity burden, and reconstructive goals, then auditing local safety and patient-reported outcomes rather than adopting a 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 whenever feasible.
Head & Neck · Tongue Reconstruction
Evaluation of Deglutition in Patients with Tongue Reconstruction Using a Radial Forearm Free Flap
This descriptive study of 30 patients found excellent swallowing after partial glossectomy and in 76.19% of hemiglossectomy patients reconstructed with a radial forearm free flap. Swallowing declined as the extent of resection increased, highlighting the need to match flap bulk and reconstructive strategy to defect size and functional goals.
Breast Reconstruction · Endoscopic Harvest
Breast Reconstruction Using the Axillary-Approach Endoscopic Extended Latissimus Dorsi (Ax-eeLD) Flap
This retrospective series describes an extended latissimus dorsi flap harvested endoscopically through a single 40-mm axillary incision and two 5-mm ports. Compared with conventional endoscopic harvest, the approach substantially shortened the incision while maintaining similar operative times and patient-reported outcomes; seroma remained the principal postoperative issue.
Chronic 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 than standard dressings. Mechanistic studies point to reduced inflammation and oxidative stress with improved angiogenesis, but small cohorts and inconsistent outcome reporting limit certainty about the optimal protocol.
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, particularly in diabetic foot ulcers. Certainty was very low because wavelengths and energy densities varied widely, including one high-dose protocol with no apparent benefit; standardized dose-response trials are needed.
Diabetic Wounds · Combination Therapy
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 · Nonthermal Plasma
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 an earlier, self-limited angiogenic response, improved collagen maturation, and normalization of TGF-β signaling, suggesting gas chemistry may shape plasma-therapy outcomes.
ADM · Antimicrobial Wound Care
1% Acetic Acid as an Effective and Cytocompatible Antimicrobial Agent with Enhanced Activity in Acellular Dermal Matrix for Wound Management
In vitro testing found 1% acetic acid inhibited clinically relevant bacteria and showed strong activity against Pseudomonas aeruginosa biofilms while preserving fibroblast viability better than povidone-iodine. Loading the acid into acellular dermal matrix maintained cytocompatibility and supported fibroblast proliferation, offering a localized antimicrobial-matrix strategy that still requires in vivo and clinical validation.
ADM · Processing and Biocompatibility
Acellular dermal matrix for chronic wound treatment: dry or wet?
This experimental comparison found wet porcine acellular dermal matrix preserved mesenchymal-stromal-cell viability and proliferation, whereas the dry variant caused marked cytotoxicity and cell death. In a porcine chronic-wound model, wet matrix accelerated stable re-epithelialization, reduced inflammatory infiltration, and improved collagen organization, supporting the importance of processing and hydration state.
ADM · Diabetic 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 · Dermal Matrix
Development and evaluation of a fish skin-derived acellular dermal matrix for diabetic wound healing: In vitro and in vivo assessment
A yellowfin-tuna skin-derived acellular dermal matrix preserved collagen structure, showed low hemolytic activity, and was biocompatible in cell and rat implantation assays. In diabetic rats, treated wounds reached complete closure by day 21 versus 90% with commercial controls, with enhanced epithelialization, hair-follicle formation, and angiogenesis; clinical translation remains untested.
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, dose-response work, and multicenter trials remain the key next steps.
Exosomes · Biomaterial Delivery
Bioactive and degradable collagen-based three-dimensional scaffold encapsulated with adipose mesenchymal stem cells-derived exosomes improved diabetic wound healing
In diabetic rats, a bioactive collagen-based three-dimensional scaffold carrying adipose-stromal-cell exosomes improved closure, epidermal and dermal formation, vascularization, collagen density, and wound biomechanics more than scaffold or exosomes alone. The combination also reduced inflammatory markers, illustrating how a carrier may improve retention and local activity, although the evidence is preclinical.
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, device malfunction and user or operator error were prominent, 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.
Dermal Fat Grafting · 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.
Autologous Reconstruction · Perforator Flaps
Total breast reconstruction using chest wall perforator flaps combined with oncoplastic techniques
This case series describes total breast reconstruction in patients unsuitable for standard free-flap or implant approaches using chest-wall perforator flaps alone or combined with Golidilocks mastectomy, multiple perforators, fat grafting, or implants. All 10 patients achieved satisfactory outcomes with minimal complications and no flap loss, supporting personalized combinations for selected patients.
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.
Robotics · Microsurgery
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.
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, while clinical validation and interoperability remain important gaps.