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Clinical Advances in Reconstructive Surgery: Innovations and Outcomes for Improved Patient Care

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "General Surgery".

Deadline for manuscript submissions: 31 July 2025 | Viewed by 5889

Special Issue Editor

Dr. Rami S. Kantar

E-Mail Website
Guest Editor
The Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY 10016, USA
Interests: reconstructive surgery; cleft surgery; cleft lip; cleft palate

Special Issue Information

Dear Colleagues,

This Special Issue, entitled "Clinical Advances in Reconstructive Surgery: Innovations and Outcomes for Improved Patient Care", focuses on the latest advancements in reconstructive surgery, with a strong emphasis on their clinical applications and impact on patient care. This Special Issue aims to provide a comprehensive overview of innovative techniques, technologies, and approaches that have significantly improved surgical outcomes and patient satisfaction.

This Special Issue aims to feature articles highlighting advancements in various areas of reconstructive surgery, including, but not limited to, cleft lip repair, breast reconstruction, facial reconstruction, hand surgery, and burn reconstruction. The articles within this Special Issue will delve into topics such as minimally invasive procedures, patient-specific treatment planning, advances in anesthesia and pain management, and the integration of regenerative medicine in reconstructive surgery.

Dr. Rami S. Kantar
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • reconstructive surgery
  • clinical advances
  • innovations
  • surgical outcomes
  • patient care
  • cleft lip repair
  • breast reconstruction
  • facial reconstruction
  • hand surgery
  • burn reconstruction
  • minimally invasive procedures
  • patient-specific treatment planning
  • anesthesia and pain management
  • regenerative medicine

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Published Papers (5 papers)

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Research

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13 pages, 4578 KiB  
Article
Comparison of MDCT Imaging and HR-pQCT for Assessment of Osseus Consolidation in Symptomatic Scaphoid Non-Union Treated with Avascular Bone Grafting and Percutaneous Screw Fixation—A Prospective Clinical Pilot Study
by Irena Krusche-Mandl, Sabrina Holzer, Kevin Döring, Arastoo Nia, Géraldine Désirée Sturz, Maximilian F. Kasparek, Janina M. Patsch, Iris-Melanie Noebauer-Huhmann, Jochen Erhart and Stefan Hajdu
J. Clin. Med. 2025, 14(5), 1476; https://doi.org/10.3390/jcm14051476 - 22 Feb 2025
Viewed by 471
Abstract
Background/objectives: This study prospectively evaluated clinical outcomes and osseous consolidation in patients with symptomatic scaphoid non-union treated with avascular bone grafting and percutaneous screw fixation. Two imaging methods, MDCT (multi-detector computed tomography) and HR-pQCT (high-resolution peripheric quantitative computer tomography), were employed to assess [...] Read more.
Background/objectives: This study prospectively evaluated clinical outcomes and osseous consolidation in patients with symptomatic scaphoid non-union treated with avascular bone grafting and percutaneous screw fixation. Two imaging methods, MDCT (multi-detector computed tomography) and HR-pQCT (high-resolution peripheric quantitative computer tomography), were employed to assess bone healing. Methods: In Vienna, eight consecutive patients with nine symptomatic scaphoid non-unions underwent revision surgery. Clinical outcomes were measured using DASH and PRWE scores, grip strength, and thumb strength. MDCT and HR-pQCT imaging were conducted 6 and 12 weeks post-operatively. Results: The median DASH score improved significantly from 43.3 (range 3.3–76.7) pre-operatively to 26.6 (p = 0.024) at 3 months and 16.2 (p = 0.06) at 12 months post-operatively. At 5–6 years, the median DASH score was 2 (range 0–15). At 6 weeks, both MDCT and HR-pQCT detected >50% bone healing at the distal interface. At the proximal interface, HR-pQCT detected >50% healing in all cases, whereas MDCT still showed <50% healing in 25% of cases. By 12 weeks, both methods demonstrated >50% osseous consolidation at both interfaces. Conclusions: Avascular iliac grafting with screw fixation achieved excellent long-term clinical outcomes for symptomatic scaphoid non-union. HR-pQCT proved superior to MDCT for assessing early bone healing. Full article
(This article belongs to the Special Issue Clinical Advances in Reconstructive Surgery: Innovations and Outcomes for Improved Patient Care)
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11 pages, 1518 KiB  
Article
Quality of Life After Microvascular Alveolar Ridge Reconstruction with Subsequent Dental Rehabilitation
by Katharina Zeman-Kuhnert, Alexander J. Gaggl, Gian B. Bottini, Joern Wittig, Christoph Steiner, Wanda Lauth and Christian Brandtner
J. Clin. Med. 2024, 13(20), 6229; https://doi.org/10.3390/jcm13206229 - 18 Oct 2024
Cited by 2 | Viewed by 768
Abstract
Background/Objectives: Defects in maxillary and mandibular alveolar ridges are common in maxillofacial practice. Reconstruction with microvascular bone grafts and subsequent prosthetic rehabilitation is the gold standard treatment. This study investigated patients’ quality of life (QoL) after microvascular alveolar ridge reconstruction with subsequent dental [...] Read more.
Background/Objectives: Defects in maxillary and mandibular alveolar ridges are common in maxillofacial practice. Reconstruction with microvascular bone grafts and subsequent prosthetic rehabilitation is the gold standard treatment. This study investigated patients’ quality of life (QoL) after microvascular alveolar ridge reconstruction with subsequent dental rehabilitation. The effect of the underlying disease and success rates of the prosthetic treatment on QoL were analysed. Methods: OHIP-49 was used to evaluate oral health-related QoL (OHrQoL). The SF-36 was used to assess disease-nonspecific QoL. Results: Fifty-eight patients were enrolled and divided into four diagnostic (malignancy, osteoradionecrosis, benign disease, and cleft palate) and five prosthetic groups (no prosthetics, removable partial dentures, complete dentures, implant-supported removable dentures, and implant-supported fixed dentures). There was a significant difference between the diagnostic groups in the total score of their OHIP-49 (p = 0.008). Patients with malignant disease and osteoradionecrosis had worse QoL scores than those with benign diseases and cleft palate. Implant-supported prostheses had the best OHrQoL. Removable partial dentures and patients in whom dental rehabilitation was not possible had the worst OHrQoL (p = 0.042). The SF-36 subscale score showed no statistically significant differences between the diagnostic and prosthetic groups (p > 0.05). Conclusions: OHrQoL after microvascular alveolar ridge reconstruction differs significantly based on underlying diagnoses and prosthetic restorations. Benign diseases and implant-supported dentures have the highest scores. Full article
(This article belongs to the Special Issue Clinical Advances in Reconstructive Surgery: Innovations and Outcomes for Improved Patient Care)
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Review

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18 pages, 1496 KiB  
Review
Advancing Auricular Reconstruction: The Evolution and Outcomes of Auricular Reconstruction Using a Porous Polyethylene (PPE) Framework
by Sara M. Hussein, Basel A. Sharaf, Samir Mardini and Waleed Gibreel
J. Clin. Med. 2025, 14(12), 4116; https://doi.org/10.3390/jcm14124116 - 10 Jun 2025
Viewed by 397
Abstract
Background/Objectives Auricular reconstruction poses significant surgical challenges in congenital and post-traumatic cases. Porous polyethylene (PPE) implants have emerged as a biocompatible alternative to the traditional autologous rib cartilage frames, offering less morbidity and a potentially stable framework. Here, we summarize the current evidence [...] Read more.
Background/Objectives Auricular reconstruction poses significant surgical challenges in congenital and post-traumatic cases. Porous polyethylene (PPE) implants have emerged as a biocompatible alternative to the traditional autologous rib cartilage frames, offering less morbidity and a potentially stable framework. Here, we summarize the current evidence of the use of PPE auricular implants. Methods: A literature search was performed in accordance with PRISMA guidelines across several databases. Studies reporting outcomes of PPE implants in auricular reconstruction were included. Data were extracted on patient characteristics, operative details, and complication rates, along with any required interventions to address complications. Complications were classified as minor or major based on their management strategy. Results: Of 544 screened studies, 14 studies representing 1036 patients were included. PPE implant use was generally linked with favorable esthetic outcomes and high patient satisfaction (80%). Study-to-study variation in complication rates was notable, with some complication rates as high as 44% in the early 1990s. By the early 2000s, advancements in surgical methods—particularly the use of temporoparietal fascia (TPF) flaps and other flaps for optimal soft tissue coverage—had markedly reduced complication rates, with recent studies reporting rates as low as 7%. Implant exposure (6.7%) and implant fractures (ranging from 1.6% to 3.2%) were the most frequently reported problems. Conclusions: PPE auricular implants, despite decades of availability, have faced limited global adoption due to concerns over complications and longevity. Advances in surgical techniques have significantly reduced complication rates (<7%), making PPE implants a viable early intervention with favorable esthetics and negligible donor-site morbidity. Full article
(This article belongs to the Special Issue Clinical Advances in Reconstructive Surgery: Innovations and Outcomes for Improved Patient Care)
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Other

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16 pages, 1429 KiB  
Systematic Review
A Comprehensive Analysis of Genioplasty in Facial Feminization Surgery: A Systematic Review and Institutional Cohort Study
by Alexis K. Gursky, Sachin R. Chinta, Hailey P. Wyatt, Maxwell N. Belisario, Alay R. Shah, Rami S. Kantar and Eduardo D. Rodriguez
J. Clin. Med. 2025, 14(1), 182; https://doi.org/10.3390/jcm14010182 - 31 Dec 2024
Cited by 1 | Viewed by 1464
Abstract
Background: Facial feminization surgery (FFS) is critical to gender-affirming surgery, consisting of craniomaxillofacial procedures to align facial features with a patient’s gender identity. Central to FFS is genioplasty, which reshapes or repositions the chin; however, limited research exists on genioplasty in FFS. This [...] Read more.
Background: Facial feminization surgery (FFS) is critical to gender-affirming surgery, consisting of craniomaxillofacial procedures to align facial features with a patient’s gender identity. Central to FFS is genioplasty, which reshapes or repositions the chin; however, limited research exists on genioplasty in FFS. This review and cohort analysis aim to evaluate current practices and outcomes for individuals undergoing FFS with genioplasty. Methods: A systematic review included transfeminine individuals undergoing FFS with genioplasty. A retrospective study reviewed FFS cases with genioplasty between 2017 and 2024. Data collected included demographics, imaging, virtual surgical planning (VSP), complications, and patient-reported outcomes (PROs). Results: The review included 12 studies with 1417 patients, with 34.2% undergoing genioplasty. The mean age was 37.3 years, and 60.1% were White. Preoperative imaging and VSP were used in 66.7% of studies, 3D-printed cutting guides in 37.5%, and 3D reconstruction in 75.0%. Reduction genioplasty was the most common technique. All PROs indicated high satisfaction, with a 2.67% revision rate. Complications were low (0.55%), with infections being most frequent (0.48%). In the institutional cohort, 351 patients underwent FFS, with 64.4% undergoing genioplasty, significantly higher than in the review (p < 0.001). Sliding genioplasty was preferred without preoperative imaging or VSP. Postoperative dissatisfaction was 3.54%, with 0.88% requiring revision (p = 0.063). Complication rates (1.77%) were similar to those of the review (p = 0.065). Conclusions: Genioplasty is important in FFS, with low complication and revision rates and high patient satisfaction. However, gaps remain in validated PROs and technique-specific outcomes. While preoperative imaging and VSP show benefits, comparable outcomes are achievable without them. Full article
(This article belongs to the Special Issue Clinical Advances in Reconstructive Surgery: Innovations and Outcomes for Improved Patient Care)
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11 pages, 660 KiB  
Systematic Review
Digital Twins Use in Plastic Surgery: A Systematic Review
by Ishith Seth, Bryan Lim, Phil Y. J. Lu, Yi Xie, Roberto Cuomo, Sally Kiu-Huen Ng, Warren M. Rozen and Foti Sofiadellis
J. Clin. Med. 2024, 13(24), 7861; https://doi.org/10.3390/jcm13247861 - 23 Dec 2024
Cited by 7 | Viewed by 2085
Abstract
Background/Objectives: Digital twin technology, initially developed for engineering and manufacturing, has entered healthcare. In plastic surgery, digital twins (DTs) have the potential to enhance surgical precision, personalise treatment plans, and improve patient outcomes. This systematic review aims to explore the current use of [...] Read more.
Background/Objectives: Digital twin technology, initially developed for engineering and manufacturing, has entered healthcare. In plastic surgery, digital twins (DTs) have the potential to enhance surgical precision, personalise treatment plans, and improve patient outcomes. This systematic review aims to explore the current use of DTs in plastic surgery and evaluate their effectiveness, challenges, and future potential. Methods: A systematic review was conducted by searching PubMed, Scopus, Web of Science, and Embase databases from their infinity to October 2024. The search included terms related to digital twins and plastic surgery. Studies were included if they focused on applying DTs in reconstructive or cosmetic plastic surgery. Data extraction focused on study characteristics, technological aspects, outcomes, and limitations. Results: After 110 studies were selected for screening, 9 studies met the inclusion criteria, covering various areas of plastic surgery, such as breast reconstruction, craniofacial surgery, and microsurgery. DTs were primarily used in preoperative planning and intraoperative guidance, with reported improvements in surgical precision, complication rates, and patient satisfaction. However, challenges such as high costs, technical complexity, and the need for advanced imaging and computational tools were frequently noted. Limited research exists on using DTs in postoperative care and real-time monitoring. Conclusions: This systematic review highlights the potential of digital twins to revolutionise plastic surgery by providing personalised and precise surgical approaches. However, barriers such as cost, complexity, and ethical concerns must be addressed. Future research should focus on validating clinical outcomes through large-scale studies and developing soft tissue modelling and real-time monitoring capabilities. Full article
(This article belongs to the Special Issue Clinical Advances in Reconstructive Surgery: Innovations and Outcomes for Improved Patient Care)
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