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Medicina
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Recent Advances in Plastic and Reconstructive Surgery
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Recent Advances in Plastic and Reconstructive Surgery

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Surgery".

Deadline for manuscript submissions: 20 August 2026 | Viewed by 9765

Special Issue Editors

Prof. Dr. Silviu Marinescu

E-Mail Website
Guest Editor Assistant
Department of Plastic and Reconstructive Surgery, “Bagdasar-Arseni” Clinical Emergency Hospital, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
Interests: regenerative medicine; non-surgical treatments; reconstructive surgery
Prof. Dr. Marius Eugen Ciurea

E-Mail Website
Guest Editor
Department of Plastic Surgery, Faculty of Medicine, County Hospital, University of Medicine and Pharmacy, Craiova, Romania
Interests: regenerative medicine; non-surgical treatments; reconstructive surgery

Special Issue Information

Dear Colleagues,

Plastic surgery has become almost synonymous with innovation, with recent developments reshaping both the aesthetic and reconstructive practices. Advancements such as minimally invasive techniques, regenerative medicine, and the use of stem cell therapy are enhancing patient outcomes by improving precision, reducing recovery times, and minimizing risks. Additionally, digital technologies like 3D printing and artificial intelligence are revolutionizing surgical planning and execution, offering unprecedented levels of customization and accuracy. The growing popularity of non-surgical treatments provides patients with more options and less invasive alternatives, further expanding the field.

As Guest Editor of the Special Issue “Recent Advances in Plastic and Reconstructive Surgery”, it is my honor to invite you to contribute your valuable research and insights regarding this topic. This Special Issue aims to showcase the latest innovations that are transforming the field of plastic surgery. We seek original articles on topics including, but not limited to, minimally invasive procedures, regenerative medicine, and non-surgical treatments, as well as new findings regarding surgical outcomes or demographics. This Special Issue represents an excellent opportunity to share your expertise and contribute to the ongoing evolution of plastic surgery.

I look forward to your contributions and the opportunity to feature your work in this program!

Prof. Dr. Silviu Marinescu
Guest Editor Assistant

Prof. Dr. Marius Eugen Ciurea
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 250 words) can be sent to the Editorial Office for assessment.

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. Medicina is an international peer-reviewed open access monthly 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 2200 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

  • minimally invasive procedures
  • regenerative medicine
  • non-surgical treatments
  • artificial intelligence
  • reconstructive surgery
  • cosmetic surgery innovations
  • patient safety

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Published Papers (5 papers)

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15 pages, 3387 KB  
Article
Automatic Apparent Nasal Index from Single Facial Photographs Using a Lightweight Deep Learning Pipeline: A Pilot Study
by Babak Saravi, Lara Schorn, Julian Lommen, Max Wilkat, Andreas Vollmer, Hamza Eren Güzel, Michael Vollmer, Felix Schrader, Christoph K. Sproll, Norbert R. Kübler and Daman D. Singh
Medicina 2025, 61(11), 1922; https://doi.org/10.3390/medicina61111922 - 27 Oct 2025
Viewed by 622
Abstract
Background and Objectives: Quantifying nasal proportions is central to facial plastic and reconstructive surgery, yet manual measurements are time-consuming and variable. We sought to develop a simple, reproducible deep learning pipeline that localizes the nose in a single frontal photograph and automatically [...] Read more.
Background and Objectives: Quantifying nasal proportions is central to facial plastic and reconstructive surgery, yet manual measurements are time-consuming and variable. We sought to develop a simple, reproducible deep learning pipeline that localizes the nose in a single frontal photograph and automatically computes the two-dimensional, photograph-derived apparent nasal index (aNI)—width/height × 100—enabling classification into five standard anthropometric categories. Materials and Methods: From CelebA we curated 29,998 high-quality near-frontal images (training 20,998; validation 5999; test 3001). Nose masks were manually annotated with the VGG Image Annotator and rasterized to binary masks. Ground-truth aNI was computed from the mask’s axis-aligned bounding box. A lightweight one-class YOLOv8n detector was trained to localize the nose; predicted aNI was computed from the detected bounding box. Performance was assessed on the held-out test set using detection coverage and mAP, agreement metrics between detector- and mask-based aNI (MAE, RMSE, R2; Bland–Altman), and five-class classification metrics (accuracy, macro-F1). Results: The detector returned at least one accepted nose box in 3000/3001 test images (99.97% coverage). Agreement with ground truth was strong: MAE 3.04 nasal index units (95% CI 2.95–3.14), RMSE 4.05, and R2 0.819. Bland–Altman analysis showed a small negative bias (−0.40, 95% CI −0.54 to −0.26) with limits of agreement −8.30 to 7.50 (95% CIs −8.54 to −8.05 and 7.25 to 7.74). After excluding out-of-range cases (<40.0), five-class classification on n = 2976 images achieved macro-F1 0.705 (95% CI 0.608–0.772) and 80.7% accuracy; errors were predominantly adjacent-class swaps, consistent with the small aNI error. Additional analyses confirmed strong ordinal agreement (weighted κ = 0.71 linear, 0.78 quadratic; Spearman ρ = 0.76) and near-perfect adjacent-class accuracy (0.999); performance remained stable when thresholds were shifted ±2 NI units and across sex and age subgroups. Conclusions: A compact detector can deliver near-universal nose localization and accurate automatic estimation of the nasal index from a single photograph, enabling reliable five-class categorization without manual measurements. The approach is fast, reproducible, and promising as a calibrated decision-support adjunct for surgical planning, outcomes tracking, and large-scale morphometric research. Full article
(This article belongs to the Special Issue Recent Advances in Plastic and Reconstructive Surgery)
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17 pages, 516 KB  
Article
Chronic Wound Management in Romania: A Survey on Practices, Protocols, and PRP Efficacy
by Stefania-Mihaela Riza, Andrei-Ludovic Porosnicu, Cristian-Sorin Hariga and Ruxandra-Diana Sinescu
Medicina 2025, 61(6), 1085; https://doi.org/10.3390/medicina61061085 - 13 Jun 2025
Cited by 2 | Viewed by 1823
Abstract
Background and Objectives: Chronic wounds pose a significant challenge to healthcare systems, requiring long-term management and multidisciplinary approaches. The absence of a standardized national therapeutic protocol in Romania has resulted in inconsistent clinical practices, which in turn affect treatment efficacy and patient outcomes. [...] Read more.
Background and Objectives: Chronic wounds pose a significant challenge to healthcare systems, requiring long-term management and multidisciplinary approaches. The absence of a standardized national therapeutic protocol in Romania has resulted in inconsistent clinical practices, which in turn affect treatment efficacy and patient outcomes. The implementation of structured guidelines and the integration of regenerative therapies could enhance the management of chronic wounds. Materials and Methods: This study employs a cross-sectional observational design to assess the current management strategies among physicians treating chronic wounds and to identify variations in treatment approaches. A 37-question questionnaire was distributed among plastic surgeons, general surgeons, vascular surgeons, and dermatologists via Google Forms. The data collection period spanned one month, resulting in a total of 240 responses from medical centers in Bucharest, Romania. Results: The study found that most physicians treated several cases per week (40.8%) of delayed healing wounds, with the most frequent types being bedsores (57.5%) and diabetic (58.3%) or venous ulcers (55%). Challenges in wound care included patient reluctance, financial constraints, and the psychological burden on caregivers. The most relevant decision factor for surgical treatment was wound stage (86.7%). Most physicians used an initial conservative approach in wound care (52.5%) or did not have a standard approach (44.2%). Around a quarter of respondents (25.8%) used PRP as a treatment method, considering it to have moderate effectiveness (51.6%). The most important factor for encouraging PRP usage was having the necessary equipment for the procedure (72.5%). The most frequently considered benefit in the case of implementing a treatment protocol was increased treatment efficacy (62.5%). Physicians were also highly interested in the use of a standardized treatment protocol (40%). Approximately 41.7% of the physicians expressed a very high interest in having a standardized diagnostic system for chronic wounds. Conclusions: This study highlights that wound care practices remain variable and that the decision-making process is often challenging. There is a moderate belief in the effectiveness of PRP, suggesting that logistical barriers need to be addressed to facilitate access to it. Therapeutic protocols were seen as key to improving care efficacy and consistency, therefore pressing the need for national strategies that support protocol development. Full article
(This article belongs to the Special Issue Recent Advances in Plastic and Reconstructive Surgery)
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14 pages, 5728 KB  
Article
A Collagen–Elastin Regenerative Dermal Matrix May Generate Unfavorable Results in Head and Neck Postburn Scar Reconstruction: A Case Series
by Bogdan Nitescu, Andrei Dumitrescu, Florin Radu Stanescu, Diana Cintacioiu, Gratiana Lates and Sorin Viorel Parasca
Medicina 2025, 61(4), 744; https://doi.org/10.3390/medicina61040744 - 17 Apr 2025
Cited by 2 | Viewed by 2132
Abstract
Background and Objectives: Dermal matrices have brought solutions for many problems, mainly in the treatment of burns and burn scar revisions. The objective of this study was to draw attention to the limits of a collagen–elastin dermal matrix (MatriDerm®) in its [...] Read more.
Background and Objectives: Dermal matrices have brought solutions for many problems, mainly in the treatment of burns and burn scar revisions. The objective of this study was to draw attention to the limits of a collagen–elastin dermal matrix (MatriDerm®) in its 1 mm variant for the treatment of burn scars on the face and neck. Materials and Methods: A case series of four patients (three women and one man) with burn scars of the face (one case) and of the neck (three cases) treated with collagen–elastin matrices is presented. In all cases, the excision or release of the scars was performed, and the defects were covered with MatriDerm® and thin split-thickness skin grafts in the same operative time. Results: In all cases, the graft take was very good but was followed by the important contraction of the graft to such an extent that the results were found to be poor by both the surgeons and the patients. The surface of the new scar was irregular, and the elasticity was low. The article points out some probable causes and draws attention to the need for more objective studies regarding the use of this dermal matrix in burn scars of the head and neck. Conclusions: This collagen–elastin 1 mm dermal matrix should be used with caution for the surgical treatment of burn scars of the head and neck area, and its indication should be carefully weighted. Full article
(This article belongs to the Special Issue Recent Advances in Plastic and Reconstructive Surgery)
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17 pages, 14047 KB  
Article
Correlation Between the Clinical and Histopathological Results in Experimental Sciatic Nerve Defect Surgery
by Andrei Marin, Vlad Herlea, Alice Bancu, Carmen Giuglea, Dana Antonia Țăpoi, Ana Maria Ciongariu, Georgiana Gabriela Marin, Silviu Adrian Marinescu, Nicoleta Amalia Dobrete, Adrian Vasile Dumitru, Cristian Trambitaș, Dragoș Șerban and Maria Sajin
Medicina 2025, 61(2), 317; https://doi.org/10.3390/medicina61020317 - 11 Feb 2025
Cited by 2 | Viewed by 2094
Abstract
Background and Objectives: Peripheral nerve defect regeneration is subject to ongoing research regarding the use of conduits associated with various cells or molecules. This article aims to correlate histopathological and clinical outcomes at the end of a 12-week experiment performed on a [...] Read more.
Background and Objectives: Peripheral nerve defect regeneration is subject to ongoing research regarding the use of conduits associated with various cells or molecules. This article aims to correlate histopathological and clinical outcomes at the end of a 12-week experiment performed on a rat sciatic nerve model and show which repair method has the best results. Materials and Methods: Forty male Wistar rats were divided into four groups to compare the results of four different methods of reconstruction for sciatic nerve defect: (1) nerve graft–control group, (2) empty aortic conduit, (3) aortic conduit filled with platelet-rich plasma (PRP) and (4) aortic conduit filled with mesenchymal stem cells. There were three clinical examinations: a sensitivity test, a mobility test and a footprint test. After 12 weeks, the nerves were excised and assessed microscopically using conventional Hematoxylin and Eosin staining (HE), special stains and immunohistochemistry (IHC). Results: Nerve regeneration was observed in all batches, both from the clinical and histopathological assessment; the two types of examinations correlated for each batch. Immunohistochemistry and special staining offered a more complete image of the nerve regeneration results. Conclusions: Superior nerve regeneration was achieved using an aortic conduit in combination with either PRP or stem cells, while the empty aortic conduit recorded lesser results. Full article
(This article belongs to the Special Issue Recent Advances in Plastic and Reconstructive Surgery)
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14 pages, 1941 KB  
Systematic Review
Effect of Autologous Skin Cell Suspensions Versus Standard Treatment on Re-Epithelialization in Burn Injuries: A Meta-Analysis of RCTs
by Faisal M. Obeid
Medicina 2025, 61(3), 529; https://doi.org/10.3390/medicina61030529 - 18 Mar 2025
Cited by 2 | Viewed by 1634
Abstract
Background and Objectives: Burn injuries, particularly partial-thickness burns, often require advanced therapies to improve re-epithelialization and scar quality. This study aims to evaluate the efficacy of autologous skin cell suspensions, such as Recell, compared to standard treatments in promoting faster and better-quality [...] Read more.
Background and Objectives: Burn injuries, particularly partial-thickness burns, often require advanced therapies to improve re-epithelialization and scar quality. This study aims to evaluate the efficacy of autologous skin cell suspensions, such as Recell, compared to standard treatments in promoting faster and better-quality skin healing. Our goal is to provide evidence-based conclusions on the effectiveness of these regenerative approaches in burn treatment. Materials and Methods: During our comprehensive investigation, we systematically examined several databases for the period to November 2024, including PubMed, Scopus, Web of Science, and the Cochrane Central Register of Controlled Trials. Our primary objective was to assess the efficacy of autologous cell suspension in treatment for burn injuries. We employed the ROB2 method to assess the quality of evidence to ensure the validity of the conclusions derived from these studies. The gathered data were systematically organized in a standardized online format and analyzed with RevMan 5.4. Results: Our systematic literature search identified nine studies (n = 358 patients) evaluating the efficacy of autologous skin cell suspensions in promoting re-epithelialization in burn injuries. The meta-analysis revealed a statistically significant reduction in time to re-epithelialization in the autologous skin cell suspension group compared to the control group (MD = −1.71 days, 95% CI [−2.73, −0.70], p = 0.001), with moderate heterogeneity among the studies (I2 = 58%). However, no significant differences were found in secondary outcomes, including postoperative pain (SMD = −0.71, 95% CI [−2.42, 1.00], p = 0.42), POSAS scores (MD = −0.35, 95% CI [−2.12, 1.42], p = 0.69), Vancouver Scar Scale (MD = −0.76, 95% CI [−2.86, 1.33], p = 0.48), or the incidence of complete healing by the 4th week (RR = 0.98, 95% CI [0.94, 1.02], p = 0.24). Similarly, no significant differences were found in postoperative infection rates (RR = 0.85, 95% CI [0.28, 2.60], p = 0.78) or the need for further interventions (RR = 0.15, 95% CI [0.02, 1.16], p = 0.07). Conclusions: autologous skin cell suspension significantly reduces the time to re-epithelialization in burn injuries compared to standard treatments. However, no significant differences were found in secondary outcomes, such as postoperative pain, scar quality (POSAS, Vancouver Scar Scale), complete healing rates, infection rates, or the need for additional interventions. While autologous skin cell suspension shows promise in accelerating re-epithelialization, it does not provide significant advantages over conventional methods in other clinical aspects. The results underscore the need for further research with larger, more robust studies to assess the long-term benefits of autologous skin cell suspension in burns carefully. Full article
(This article belongs to the Special Issue Recent Advances in Plastic and Reconstructive Surgery)
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