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Grand RoundsWeekly Evidence Brief

Plastic Surgery

Edition

30-Second Takeaway

  • Drug-loaded meshes and smart hydrogels could reduce infection and scar burden around implants and keloids.
  • Microneedle and hydrogel platforms deliver pathology-triggered, localized therapy for hypertrophic scars and keloids.
  • Engineered adipose scaffolds and vesicle-based systems refine strategies for durable, vascularized soft-tissue volume restoration.
  • High-frequency and contrast-enhanced ultrasound enable reliable lymphatic mapping when ICG lymphography is non-diagnostic.
  • Long-term 3D virtual planning data support routine patient-specific implants in mandibular reconstruction, with attention to plate exposure risk.

Week ending January 31, 2026

Targeted biomaterials, imaging, and planning tools are reshaping reconstructive plastic surgery

Laser-structured triclosan polypropylene mesh improves antibacterial performance and healing in breast reconstruction model

ADVANCED HEALTHCARE MATERIALSJan 27, 2026

Femtosecond laser micro/nanostructuring of polypropylene mesh markedly increased triclosan loading and antibacterial activity versus unmodified mesh. In a rat breast reconstruction model, triclosan-modified mesh accelerated scab formation and wound closure compared with blank controls. Implants showed higher CD31 and CD163 levels and lower IL-6 and TNF-α, indicating increased vascularity and reduced inflammation. Mechanical properties remained suitable for reconstruction, suggesting potential applicability to infection-prone implant-based breast surgery.

ROS-adaptive asiatic-acid microneedles remodel hypertrophic scar microenvironment in rabbits

JOURNAL OF NANOBIOTECHNOLOGYJan 25, 2026

A hyaluronic acid dissolving microneedle array delivered ROS-responsive asiatic acid nanoparticles directly into hypertrophic scars. Nanoparticles released asiatic acid in response to elevated ROS, enabling sustained, lesion-specific drug delivery within scar tissue. In vitro, treatment selectively inhibited hypertrophic scar fibroblast proliferation and reduced macrophage migration. In a rabbit ear hypertrophic scar model, microneedles reduced scar thickness, normalized collagen architecture, and suppressed fibrosis. RNA sequencing showed coordinated downregulation of proliferation, inflammation, and collagen deposition pathways, consistent with a more regenerative scar phenotype.

HFUS plus CEUS reliably maps lymphatics for LVA when ICG lymphography lacks a linear pattern

EUROPEAN RADIOLOGYJan 24, 2026

Among 111 lymphedema patients without a clear linear ICG pattern, high-frequency and contrast-enhanced ultrasound identified lymphatics suitable for LVA. Combined HFUS+CEUS detected 313 lymphatics with 91.1% accuracy versus operative findings, exceeding HFUS or CEUS alone. Measured lymphatic diameters were 0.5–0.9 mm with depths around 9–10 mm, informing supermicrosurgical anastomosis planning. Postoperative limb circumference and volume significantly decreased, supporting the clinical utility of ultrasound-guided mapping in ICG-negative cases.

Common 1% O2 hypoxic preconditioning impairs nanofat-driven vascularization in vivo

CELLSJan 28, 2026

Mouse nanofat preconditioned at 1% O2 for 24 hours preserved viability and upregulated HIF-1α and SDF-1 versus normoxia. Protein profiling indicated a pro-angiogenic signature ex vivo in hypoxia-treated nanofat. However, dermal substitutes seeded with preconditioned nanofat showed significantly reduced functional microvessel density in vivo compared with non-preconditioned controls. Immunohistochemistry confirmed lower microvessel density in the hypoxia group. These data argue against using 1% O2 for 24 hours to enhance nanofat vascularization capacity in reconstructive applications.

References

Numbered in order of appearance. Click any reference to view details.

Additional Reads

Optional additional studies from this edition.

Edition context

Clinical signal

  • Multiple preclinical biomaterial platforms—triclosan meshes, bilayer skin scaffolds, adipose vesicle delivery—aim to improve integration and reduce complications in reconstruction.
  • Standard 1% O2 for 24 h hypoxic preconditioning may impair nanofat-driven vascularization despite pro-angiogenic ex vivo signaling.
  • Ultra-local scar and keloid treatment is moving toward microneedles and smart hydrogels with microenvironment-triggered release and symptom relief.