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Clinical Progress in Microsurgical Reconstruction: 2nd Edition

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

Deadline for manuscript submissions: 25 September 2025 | Viewed by 320

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Guest Editor
Maxillofacial Surgery Operative Unit, Department of Mental Health and Sense Organs, Santa Maria Le Scotte, University Hospital of Siena, 53100 Siena, Italy
Interests: plastic and reconstructive surgery; microsurgery; facial plastic surgery; maxillofacial surgery; head and neck surgery
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Special Issue Information

Dear Colleagues,

It is my pleasure to invite you to contribute to this Special Issue entitled “Clinical Progress in Microsurgical Reconstruction: 2nd Edition”. In our previous Special Issue entitled “Clinical Progress in Microsurgical Reconstruction”, we collected high-standard original articles and review papers covering a wide range of topics. This is a continuation of the previous series.

Microsurgery is a fundamental cornerstone of the armamentarium of a reconstructive surgeon and often represents the only resource available to manage complex and challenging post-traumatic or post-oncological defects, morbid conditions such as lymphedema, and reconstructive needs like genital gender-affirming surgery, which is essential for a patient’s self-perception and social life.

Since the 2000s, new technological tools, such as microvascular anastomotic coupling devices, major improvements in magnification in the surgical field associated with fluorescence for assessing patency and microvascular perfusion, the spread of effective software for Virtual Surgical Planning (VSP), and the introduction of augmented reality, have brought new excitement regarding microsurgery and its future applications.

This progress in the field of microsurgery provides the opportunity to greatly increase the final treatment outcomes for patients in a predictable manner, with significant reductions in morbidity, invasivity, and recovery time, and improvements in functional and esthetic results.

The aim of this Special Issue is to emphasize these improvements through the publication of papers addressing the above topics with solid scientific evidence. Basic research papers, clinical papers, and reviews focused on clinical progress in microsurgical reconstruction are all highly encouraged for submission.

Dr. Olindo Massarelli
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
  • supermicrosurgery
  • microvascular anastomosis
  • head and neck reconstruction
  • oro-maxillofacial re-construction
  • plastic and reconstructive surgery
  • limb reconstruction
  • breast reconstruction
  • genital reconstruc-tion
  • lymphedema
  • lymph nodes transfer
  • facial reanimation

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Published Papers (1 paper)

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Review

15 pages, 362 KiB  
Review
Artificial Intelligence in Microsurgical Planning: A Five-Year Leap in Clinical Translation
by Omar Shadid, Ishith Seth, Roberto Cuomo, Warren M. Rozen and Gianluca Marcaccini
J. Clin. Med. 2025, 14(13), 4574; https://doi.org/10.3390/jcm14134574 - 27 Jun 2025
Viewed by 177
Abstract
Background: Microsurgery is a highly complex and technically demanding field within reconstructive surgery, with outcomes heavily dependent on meticulous planning, precision, and postoperative monitoring. Over the last five years, artificial intelligence (AI) has emerged as a transformative tool across all phases of microsurgical [...] Read more.
Background: Microsurgery is a highly complex and technically demanding field within reconstructive surgery, with outcomes heavily dependent on meticulous planning, precision, and postoperative monitoring. Over the last five years, artificial intelligence (AI) has emerged as a transformative tool across all phases of microsurgical care, offering new capabilities in imaging analysis, intraoperative decision support, and outcome prediction. Methods: A comprehensive narrative review was conducted to evaluate the peer-reviewed literature published between 2020 and May 2025. Multiple databases, including PubMed, Embase, Cochrane, Scopus, and Web of Science, were searched using combinations of controlled vocabulary and free-text terms relating to AI and microsurgery. Studies were included if they described AI applications during the preoperative, intraoperative, or postoperative phases of microsurgical care in human subjects. Discussion: Using predictive models, AI demonstrated significant utility in preoperative planning through automated perforator mapping, flap design, and individualised risk stratification. AI-enhanced augmented reality and perfusion analysis tools improved precision intraoperatively, while innovative robotic platforms and intraoperative advisors showed early promise. Postoperatively, mobile-based deep learning applications enabled continuous flap monitoring with sensitivities exceeding 90%, and AI models accurately predicted surgical site infections, transfusion needs, and long-term outcomes. Despite these advances, most studies relied on retrospective single-centre data, and large-scale, prospective validation remains limited. Conclusions: AI is poised to enhance microsurgical precision, safety, and efficiency. However, its integration is challenged by data heterogeneity, generalisability concerns, and the need for human oversight in nuanced clinical scenarios. Standardised data collection and multicentre collaboration are vital for robust, equitable AI deployment. With careful validation and implementation, AI holds the potential to redefine microsurgical workflows and improve patient outcomes across diverse clinical settings. Full article
(This article belongs to the Special Issue Clinical Progress in Microsurgical Reconstruction: 2nd Edition)
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