Plastic and Reconstructive Surgery Global Open最新文献

{"title":"Artificial Intelligence and Robotic Surgery in Lymphedema: A Scoping Review of Current Applications, Clinical Translation, and Evidence Gaps.","authors":"Adriano Fabi, Séverin R Wendelspiess, Felix J Klimitz, Aliyar Zahedi Vafa, Matteo Meroni, André S Alves, Yvonne Haas, Christoph Wallner, Siba Haykal, Elisabeth A Kappos","doi":"10.1097/GOX.0000000000008082","DOIUrl":"10.1097/GOX.0000000000008082","url":null,"abstract":"<p><strong>Background: </strong>Lymphedema is a debilitating disease, in which timely diagnosis and standardized monitoring are essential to prevent progression. Artificial intelligence (AI) has increasingly been applied in other surgical disciplines. Therefore, this review summarizes current AI applications in lymphedema management and explores their potential for clinical translation.</p><p><strong>Methods: </strong>The PubMed/MEDLINE database was searched from inception to June 2025 for studies on lymphedema and AI. Peer-reviewed primary studies were included; editorials, reviews, and commentaries were excluded. All reference lists were screened for additional studies. Findings were synthesized qualitatively and grouped by clinical task.</p><p><strong>Results: </strong>Existing studies primarily evaluate AI for risk prediction, symptom- or image-based screening, automated volumetry, and lymphatic imaging interpretation. Reported performance is frequently high in single-center retrospective datasets; however, external validation and prospective workflow evaluation remain uncommon. Consequently, current applications are largely experimental and rarely used in clinical practice.</p><p><strong>Conclusions: </strong>The integration of AI-assisted systems into the surgical management of chronic lymphedema has the potential to reduce diagnostic delays and to enable early therapeutic intervention. Additionally, it may improve surgical simulation, training, and real-time support in robotic (super-)microsurgery, thereby enhancing personalized patient care. However, translation to routine practice will require multicenter validation, transparent reporting, and demonstration of clinical utility, cost-effectiveness, and safety.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"14 9","pages":"e8082"},"PeriodicalIF":1.9,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13537723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dynamic External Distraction Device for Proximal Phalangeal Head Intra-articular Fracture.","authors":"Tzu-Chi Tseng, Kun-Han Lee, Jung-Pan Wang","doi":"10.1097/GOX.0000000000008044","DOIUrl":"https://doi.org/10.1097/GOX.0000000000008044","url":null,"abstract":"<p><p>Dynamic distraction external fixation (DDEF) is commonly used for proximal interphalangeal joint fractures based on the principle of ligamentotaxis. However, this mechanism may be limited when fracture fragments lack soft tissue attachment. We present a 14-year-old girl with a depressed intra-articular fracture of the proximal phalanx head and joint stiffness, treated 5 weeks after injury using DDEF. Despite delayed treatment and minimal ligamentous connection, the fragment was successfully elevated and healed. We propose the so-called \"vacuum phenomenon\" as a hypothesis-generating concept that may represent a supplementary mechanism in fracture reduction under distraction. This effect may be particularly relevant in cases where ligamentotaxis alone does not fully explain fragment repositioning, and may help broaden the understanding of DDEF in managing such injuries.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"14 9","pages":"e8044"},"PeriodicalIF":1.9,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13581353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rectus-based Stoma and Rectus Abdominis Myocutaneous Flap Laterality Planning for Perineal-Anal Defects After Hemipelvectomy.","authors":"Hisataka Takeuchi, Shinnosuke Yamashita, Masataka Tanimoto, Takashi Honjo, Yoshihiro Tsukamoto, Yuki Segawa, Satoshi Ota, Eijiro Onishi, Tadashi Yasuda","doi":"10.1097/GOX.0000000000008053","DOIUrl":"https://doi.org/10.1097/GOX.0000000000008053","url":null,"abstract":"<p><p>Perineal-anal defects are difficult to manage because negative-pressure wound therapy (NPWT) commonly fails to achieve an airtight seal, and stool contamination hinders wound-bed preparation. Fecal diversion is often required, with a stoma typically created within the rectus abdominis muscle. When a rectus abdominis myocutaneous (RAM) flap is planned, the stoma and flap must be placed on opposite sides, making laterality planning essential. Assessment of the deep inferior epigastric artery (DIEA) patency is critical because vascular compromise may limit flap harvesting. Herein, we report a rare case of pelvic necrotizing soft-tissue infection (NSTI) requiring hemipelvectomy in which coordinated stoma planning, vascular evaluation, and RAM flap reconstruction enabled successful treatment. A 63-year-old woman presented with a fulminant NSTI extending from the lower limbs to the pelvis. Despite emergency hip disarticulation, the infection progressed, necessitating a hemipelvectomy. To allow complete NPWT coverage, fecal diversion was planned. Preoperative computed tomography angiography revealed right DIEA occlusion, precluding RAM flap harvesting on that side; therefore, a \"left-sided\" RAM flap was selected, with the stoma created within the \"right\" rectus abdominis muscle. After hemipelvectomy and repeat NPWT-assisted debridement, definitive reconstruction using a left RAM flap with skin grafting achieved stable wound coverage. Successful reconstruction after hemipelvectomy for NSTI requires reliable DIEA evaluation, precise laterality planning, and coordinated multidisciplinary management. Preoperative computed tomography angiography is critical to determine the appropriate side for stoma creation and preserve the RAM flap donor muscle. A structured sequence integrating fecal diversion, NPWT, and flap selection enables safe and definitive soft-tissue closure.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"14 9","pages":"e8053"},"PeriodicalIF":1.9,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13581386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Local Tranexamic Acid in Rhytidectomy: A Systematic Review and Meta-analysis.","authors":"Jonathan Mokhtar, Marwa Hadi, Lucas Kreutz-Rodrigues, Kevin Sadati, Krishna S Vyas, Curtis L Cetrulo, Alexandre G Lellouch","doi":"10.1097/GOX.0000000000008083","DOIUrl":"10.1097/GOX.0000000000008083","url":null,"abstract":"<p><strong>Background: </strong>Rhytidectomy is one of the most performed facial rejuvenation procedures, yet postoperative hematoma remains its most frequent and consequential complication, driving patient morbidity and compromising aesthetic outcomes. Tranexamic acid (TXA), a potent antifibrinolytic agent, has been widely adopted to mitigate surgical bleeding; however, a definitive high-level synthesis of evidence for its local application in rhytidectomy remains limited. We conducted a comprehensive systematic review and meta-analysis to highlight the efficacy and safety profile of local administration of TXA compared with control interventions in patients undergoing rhytidectomy.</p><p><strong>Methods: </strong>A systematic search of PubMed, Embase, MEDLINE (EBSCO), and Cochrane Central Register of Controlled Trials (CENTRAL) was conducted from database inception through December 2025. Studies comparing the effects of local administration of TXA with a control in adults undergoing rhytidectomy were included. Pooled effect estimates were calculated using a random-effects model; risk of bias was assessed with risk of bias in non-randomized studies-of interventions (ROBINS-I); and the certainty of evidence was appraised using the grading of recommendations assessment, development, and evaluation (GRADE) framework.</p><p><strong>Results: </strong>Seven studies met the inclusion criteria, comprising 1122 patients (596 local TXA and 526 controls). Meta-analysis revealed that local TXA was associated with a significant reduction in estimated blood loss (in milliliters) (standardized mean difference, -4.53; 95% confidence interval [CI], -8.09 to -0.97; <i>P</i> = 0.01), 24-hour postoperative drain output (in milliliters) (standardized mean difference, -1.10; 95% CI, -1.40 to -0.79; <i>P</i> < 0.01), and hematoma rates (odds ratio, 0.35; 95% CI, 0.15-0.81; <i>P</i> = 0.014).</p><p><strong>Conclusions: </strong>In patients undergoing rhytidectomy, the application of local TXA significantly enhances surgical efficiency and patient safety by reducing blood loss, drain output, and postoperative hematologic complications.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"14 9","pages":"e8083"},"PeriodicalIF":1.9,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13537715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Fujiyama Procedure: A Triangular Skin Paddle Design for Restoring Natural Ptosis in Implant-to-autologous Breast Reconstruction.","authors":"Hajime Matsumine, Hiroyuki Sakurai","doi":"10.1097/GOX.0000000000008108","DOIUrl":"10.1097/GOX.0000000000008108","url":null,"abstract":"<p><p>The Fujiyama procedure is a surgical technique designed for patients undergoing conversion from implant-based breast reconstruction to autologous tissue reconstruction. Conventional implant-to-flap conversion often fails to reproduce natural breast ptosis and lower pole projection because of biomechanical differences between implants and autologous tissue and an insufficient lower pole skin envelope after long-term implant placement. This technique applies the inverted-T mastopexy concept in reverse and introduces a geometric redesign strategy, in which a triangular skin paddle is intentionally exposed at the lower pole. This design allows redistribution of the skin envelope while providing adequate lower pole volume and skin supply, both of which are essential for restoring a natural ptotic contour. Following implant and capsule removal, the pectoralis major muscle is repositioned to the chest wall, and a prepectoral pocket is created to optimize softness and contour. The transferred flap is inserted into this plane, and the exposed skin paddle forms the \"Fujiyama-shaped\" lower pole. Intraoperative assessment in sitting position under negative pressure enables contour adjustment. When necessary, the inframammary fold is reinforced using multiple tacking sutures. Seven patients (9 breasts) underwent reconstruction using pedicled or free abdominal flaps and profunda artery perforator flaps. Complete flap survival without major or minor complications was achieved in all cases. Stable inframammary fold reconstruction, natural breast ptosis, and lower pole projection were achieved without secondary revisions. The Fujiyama design represents a structural lower pole redesign rather than simple implant replacement and offers an option for restoring natural breast morphology in secondary autologous reconstruction.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"14 9","pages":"e8108"},"PeriodicalIF":1.9,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13537712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound-guided Minimally Invasive Correction of Postblepharoplasty Lower Eyelid Hollowing Using Hyaluronic Acid: A 5-case Series.","authors":"Kikuno Onchi, Chihiro Matsui","doi":"10.1097/GOX.0000000000008055","DOIUrl":"https://doi.org/10.1097/GOX.0000000000008055","url":null,"abstract":"<p><p>Lower eyelid hollowing is a challenging complication following transconjunctival blepharoplasty, particularly in Asian patients with limited midface projection. Surgical revision is often unpredictable due to fibrosis, thin skin, and compromised vascularity. Minimally invasive alternatives that provide reliable contour restoration with minimal downtime are desirable. This case series includes 5 female patients presenting with persistent lower eyelid hollowing at least 3 months after transconjunctival fat removal. All patients underwent ultrasound-guided hyaluronic acid (HA) injection using a blunt cannula, with selective adhesiolysis when indicated. HA fillers were chosen based on rheological properties: VYC-17.5L for sub-orbicularis oculi fat and periosteal augmentation, and VYC-15L for periosteal and sub-orbicularis oculi muscle tear trough correction. One patient with extremely thin skin and vascular dark circles received adjunctive subcutaneous human-derived collagen. Outcomes were assessed clinically and via standardized photography at 1 and 3 months, with patient satisfaction measured using a 5-point Likert scale. All patients demonstrated visible improvement in lower eyelid contour at both follow-up visits. Patient satisfaction was high, with 4 of 5 patients reporting being very satisfied and 1 reporting being satisfied at the 3-month follow-up. Transient edema and ecchymosis occurred in 2 patients each and resolved spontaneously. No Tyndall phenomenon, vascular complications, nodules, or contour irregularities were observed. Ultrasound-guided HA injection may represent a safe and minimally invasive option for selected patients with postblepharoplasty lower eyelid hollowing, achieving favorable short-term aesthetic outcomes with high patient satisfaction.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"14 9","pages":"e8055"},"PeriodicalIF":1.9,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13581378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complication Rates in Facial Feminization Surgery: A Systematic Review.","authors":"Sjoerd F P van der Velden, Daan J Rademakers, Tong Xi, Tim H J Nijhuis","doi":"10.1097/GOX.0000000000008081","DOIUrl":"https://doi.org/10.1097/GOX.0000000000008081","url":null,"abstract":"<p><strong>Background: </strong>Facial feminization surgery (FFS) is vital for the well-being of transgender women and nonbinary individuals. FFS procedures involve different surgical techniques that are accompanied by a broad range of complications. This article aims to identify the complication risks of surgical procedures applied in FFS following the Clavien-Dindo classification.</p><p><strong>Methods: </strong>A systematic review was performed in accordance with the Cochrane Handbook for Systematic Reviews of Interventions and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines. PubMed, Embase, Cochrane, and Web of Science databases were queried. Data were acquired and divided into 6 subgroups, covering all feminization features of the face and neck, including combined procedures.</p><p><strong>Results: </strong>Forty-eight studies were included in the systematic review. The cohorts ranged from 4 to 1049 patients. The follow-up ranged from 3 weeks to 110 months. The overall risk incidence of complications, including infection, nonunion of bony fragments, and deep venous thrombosis after surgery, was less than 5% across all subgroups regarding the face and neck. The complication rate for combined surgery was 5.3%.</p><p><strong>Conclusions: </strong>This article describes a low incidence of complications following FFS, suggesting that these are safe procedures with minimal risks to patients. The identified risk ratios can aid clinicians and patients in making informed decisions regarding the selection of appropriate surgical techniques in FFS.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"14 9","pages":"e8081"},"PeriodicalIF":1.9,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13581374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Biophysical Stimulation Therapy in Surgically Treated Acute Scaphoid Fractures.","authors":"Carmine Scarlato, Macarena Vizcay, Nicoletta Denami, Andrea Ghezzi, Giorgio Eugenio Pajardi","doi":"10.1097/GOX.0000000000008093","DOIUrl":"10.1097/GOX.0000000000008093","url":null,"abstract":"<p><strong>Background: </strong>Scaphoid fractures remain challenging because of the bone's limited vascularity, particularly at the proximal pole. Although surgical fixation represents the standard of care for displaced and high-risk fractures, pulsed electromagnetic field (PEMF) stimulation has been proposed as a noninvasive adjunctive therapy, with osteogenic, anti-inflammatory, bone-healing, and regenerative effects.</p><p><strong>Methods: </strong>This multicenter retrospective cohort study, conducted in accordance with the strengthening the reporting of observational studies in epidemiology (STROBE) guidelines, evaluated PEMF stimulation as an adjunctive treatment in acute surgically treated scaphoid fractures. Data from 26 male patients, aged 32 ± 13 years, treated between 2020 and 2023, with more than 1 year of follow-up, were analyzed. All patients underwent cannulated screw fixation and an early mobilization rehabilitation protocol. Radiographic consolidation, return to work, wrist pain (numeric pain rating scale), and disability in daily activities (Patient-Rated Wrist Evaluation) were evaluated and compared between the 2 groups.</p><p><strong>Results: </strong>Ten patients received postoperative PEMF stimulation and 16 served as controls. Radiographic consolidation occurred significantly earlier in the PEMF group (<i>P</i> = 0.024). No significant differences were observed in return to work or Patient-Rated Wrist Evaluation scores. Pain at rest was significantly lower in the PEMF group (<i>P</i> = 0.048). These results support the existing evidence on the biological impact of PEMF on bone healing and pain modulation; however, the small sample size and retrospective design limit causal inference.</p><p><strong>Conclusions: </strong>PEMF stimulation may represent a safe, noninvasive adjunct after surgical fixation of acute scaphoid fractures, potentially accelerating radiographic consolidation and reducing long-term wrist pain. Larger prospective studies are warranted.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"14 9","pages":"e8093"},"PeriodicalIF":1.9,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13537718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fibrinogen Immunostaining in a Single Case of an Earlobe Keloid: A Case Report and Literature Review.","authors":"Yusaku Saijo, Teruyuki Dohi, Haruko Watanabe-Takano, Shigetomo Fukuhara, Rei Ogawa","doi":"10.1097/GOX.0000000000008079","DOIUrl":"https://doi.org/10.1097/GOX.0000000000008079","url":null,"abstract":"<p><p>Abnormal scars, such as keloids and hypertrophic scars, are fibroproliferative disorders that develop following wounds or infections extending into the reticular dermis, with cutaneous mechanical tension considered an aggravating factor. The detailed mechanisms underlying keloid formation and patterns of extension remain unclear. Recent studies suggest that microvascular hyperpermeability, potentially resulting from structural alterations in the vascular basement membrane and increased microvascular density in the superficial dermis, may contribute to keloid development. We report a single case of an earlobe keloid treated with surgical excision followed by postoperative radiotherapy (8 Gy in a single fraction). The resected tissue was histologically confirmed as a keloid. Immunohistochemical staining for fibrinogen and CD31 was performed on cryosections to evaluate vascular permeability. Fluorescence images were acquired using a confocal laser scanning microscope. The patient showed no recurrence during at least 12 months of follow-up. Fibrinogen deposition was observed predominantly in the superficial dermis at the keloid apex, with stronger signals than those in deeper regions of the keloid and adjacent normal skin. Fibrinogen is a key factor in wound healing and fibrosis, and its deposition within the extracellular matrix may reflect vascular hyperpermeability. Our findings suggest that areas of fibrinogen leakage may represent potential sites of future collagen deposition and keloid progression. However, this observation is based on a single case, and further studies are warranted to clarify the role of fibrinogen in keloid pathogenesis.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"14 9","pages":"e8079"},"PeriodicalIF":1.9,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13581380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolution and Hotspots in Autologous Ear Reconstruction: A Bibliometric Analysis of the 100 Most-cited Studies.","authors":"Charbel G Saad, Laurentia Fidella Averina Setia Santoso, Rola Mahdi, Soumiya Nadar, Thenuli Tamasha Jayamaha Hitihamilage, Nancy Emmanuel, Juan Pablo Menendez, Gregory Nicolas","doi":"10.1097/GOX.0000000000008056","DOIUrl":"https://doi.org/10.1097/GOX.0000000000008056","url":null,"abstract":"<p><strong>Background: </strong>Autologous auricular reconstruction has evolved from cartilage-carving techniques that established modern microtia repair to an expanding regenerative and biofabrication literature. However, the field has not been mapped bibliometrically using an autologous-only lens that separates the clinical literature from emerging tissue-engineering hotspots.</p><p><strong>Methods: </strong>A Scopus search in January 2026 identified publications on autologous auricular reconstruction. Records were sorted by citation count, screened for eligibility, and the 100 most-cited studies were included. Data extracted included citations, citations per year, year, journal, country, and evidence category. Studies were classified into 4 domains: surgical technique, tissue engineering/basic science, complications/management, and outcomes/quality of life. VOSviewer was used for coauthorship and keyword co-occurrence mapping. Temporal shifts were assessed by comparing the older versus newer halves.</p><p><strong>Results: </strong>The 100 most-cited studies (1971-2023) accrued a mean of 82.97 citations (range, 27-510) with a median of 3.46 citations per year. Most studies were clinical (71%), followed by preclinical (19%) and evidence synthesis (10%). Surgical technique predominated overall (53%), but decreased from 66% in the older half to 40% in the newer half, whereas tissue engineering increased from 16% to 28%. The most-cited article was the description by Nagata of a 2-stage, 3-dimensional costal cartilage framework (1993, <i>Plastic and Reconstructive Surgery</i>). Keyword clustering revealed a temporally newer regenerative cluster centered on chondrocytes, tissue engineering, and biomechanics.</p><p><strong>Conclusions: </strong>The citation canon of autologous auricular reconstruction is built on the late 20th-century technique classics, whereas contemporary influence is increasingly driven by regenerative medicine and biofabrication. Future high-impact work will likely be defined by durable, shape-stable engineered constructs validated in clinically relevant models.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"14 9","pages":"e8056"},"PeriodicalIF":1.9,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13581356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}