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Microsurgery: Current and Future Challenges
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Microsurgery: Current and Future Challenges

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Plastic, Reconstructive and Aesthetic Surgery/Aesthetic Medicine".

Deadline for manuscript submissions: 25 June 2025 | Viewed by 1010

Special Issue Editor

Dr. Matthias Aitzetmüller-Klietz

E-Mail Website
Guest Editor
1. Department of Plastic Surgery, University Hospital Muenster, 48149 Muenster, Germany
2. Department for Plastic, Aesthetic, Hand- and Reconstructive Surgery, Klinikum Passau, University Campus Lower Bavaria, 94032 Passau, Germany
Interests: breast surgery; breast reconstruction; facial plastic surgery
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Currently, no subfield in plastic surgery is undergoing as many changes as the field of microsurgery. Technical innovations have driven and allowed for a surgical evolution with novel treatment options and simultaneous improvement of outcome.

Innovations such as robotic-assisted microsurgery or Artificial Intelligence, have the potential to change the whole field of microsurgery. But when transferring from bench to bedside, all of these innovations are facing the same obstacles: initially prolonged surgery time, concerns regarding patient safety, high costs or problems in patient selection- just to mention some of them. Some innovations are overcoming these hurdles, but many are failing to make the step into everyday clinical practice.

This Special Issue focuses on challenges in microsurgery—because it is not about having a solution and creating a problem, but about having a problem and finding a solution.

We are looking forward to receiving papers about your problems and solutions in microsurgery.

Dr. Matthias Aitzetmüller-Klietz
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

  • microsurgery
  • reconstruction
  • reconstructive surgery
  • breast reconstruction
  • extremity reconstruction

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Published Papers (2 papers)

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Research

11 pages, 3672 KiB  
Article
Pelvic and Perineal Reconstruction After Bowel, Gynecological or Sacral Tumor Resection: A Case Series
by Aikaterini Bini and Spyridon Stavrianos
J. Clin. Med. 2025, 14(9), 3172; https://doi.org/10.3390/jcm14093172 - 3 May 2025
Viewed by 359
Abstract
Background/Aim: Perineal, pelvic and urogenital reconstruction presents a challenge, not only due to defect size but also due to high morbidity resulting from surgery and post-operative complications. The purpose of this study is to review the surgical approach and evaluate the results regarding [...] Read more.
Background/Aim: Perineal, pelvic and urogenital reconstruction presents a challenge, not only due to defect size but also due to high morbidity resulting from surgery and post-operative complications. The purpose of this study is to review the surgical approach and evaluate the results regarding pelvic/perineal reconstruction after advanced tumor resection. Patients and Methods: The total number of patients was 34 (11 males, 23 females). The histology varied, including sixteen rectal-anal squamous cell carcinomas, five Buschke-Lowenstein tumors, four vulvar-vaginal carcinomas, four sacral chordomas, two cutaneous squamous cell carcinomas, two soft tissue sarcomas and a case of Paget’s disease. Most patients had previously been treated with colectomies and/or gynecological resections and received a full dose of radiotherapy. Reconstruction was performed with the following flaps: oblique/vertical rectus abdominis myocutaneous flap (ORAM/VRAM), gracilis myocutaneous flap, inferior gluteal artery perforator flap (IGAP), internal pudendal artery perforator flap (IPAP) and lotus petal flaps. Results: Most patients had a relatively uncomplicated post-operative course. Surgical site infection and wound dehiscence occurred more commonly with the thigh flaps rather than the abdominal flaps. However, the aggression and the frequent recurrences of these tumors had as a result, only 15 out of 34 patients achieved a five-year disease-free survival. Conclusions: Pelvic and perineal defects are usually massive and the use of myocutaneous flaps to eliminate the dead space is of paramount importance. Although these are mainly salvage operations with a low survival rate, they promote patients’ quality of life. A frequent challenge is the simultaneous achievement of tumor radical resection and pelvis functionality. Full article
(This article belongs to the Special Issue Microsurgery: Current and Future Challenges)
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9 pages, 2433 KiB  
Article
Lessons Learned from Reconstructing Severe Hand Injuries During the COVID-19 Pandemic
by Christina Glisic, Tonatiuh Flores, Erol Konul, Hugo Sabitzer, Giovanni Bartellas, Alexander Rohrbacher, Berfin Sakar, Sascha Klee, Uwe Graichen, Patrick Platzer, Klaus F. Schrögendorfer and Konstantin Bergmeister
J. Clin. Med. 2025, 14(7), 2169; https://doi.org/10.3390/jcm14072169 - 22 Mar 2025
Viewed by 366
Abstract
Background: COVID-19 presented many challenges for our health system, one being a suspected change in the epidemiology of severe hand trauma modalities. These complex injuries are traditionally treated at specialized hand trauma centers, but COVID-19 has in many ways disturbed these established [...] Read more.
Background: COVID-19 presented many challenges for our health system, one being a suspected change in the epidemiology of severe hand trauma modalities. These complex injuries are traditionally treated at specialized hand trauma centers, but COVID-19 has in many ways disturbed these established pathways and presented new challenges. Methods: We retrospectively analyzed finger amputation injuries treated at the University Hospital of St. Poelten between 2018 and 2022 to examine differences in the management of micro amputation injuries before and during the COVID-19 pandemic. Further challenges in the treatment of hand trauma patients were analyzed and solutions were developed. Results: Overall, the number of occupational finger amputation injuries in Lower Austria declined during the COVID-19 pandemic. Contrarily, more private accidents were treated in the same period, suggesting a lockdown specific change in injury characteristics. Throughout the entire examined period, a total of 130 injured fingers, including 29 thumbs, were treated. In 67 cases, a reconstruction attempt was feasible and successful in 59 cases. Specific challenges were fewer active hand trauma centers, subsequent long transport times, specific COVID-19 prevention measures, and limited postoperative rehabilitation resources. Conclusions: Despite many challenges overall affecting the time to revascularization, good results were achieved by small but meaningful modifications. These included well-established principles such as back table preparation and strengthening novel concepts such as tele-medicine for patient selection. Overall, the reconstruction of severe hand injuries is often challenging, especially during a world-wide health crisis, but with adequate solutions, good results can be readily achieved. Full article
(This article belongs to the Special Issue Microsurgery: Current and Future Challenges)
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