Plastic Surgery

AI “HoloTrauma 3X” co-reasoning streamlines occlusion–bone–airway management in maxillofacial trauma

HoloTrauma 3X uses vision–language AI to assess the occlusion–bone–airway triad in emergency maxillofacial trauma. In 8,427 trauma patients from 12 institutions, it achieved sub-millimeter average absolute error for maxillary and mandibular positioning. Use of HoloTrauma 3X reduced operative time by 31.4% compared with standard techniques. Surgical complications decreased by 42.3% versus conventional methods, suggesting AI-guided planning may improve both efficiency and safety. 1

Axolotl-mimetic low-stiffness silk hydrogel drives scarless-like cutaneous healing via Piezo1/YAP and M2 macrophages

This study engineered silk-based hydrogels with tunable stiffness to mimic axolotl, mouse, and human scar biomechanics. The axolotl-like low-modulus gel (ERegen-gel) remodeled the wound bed to favor scarless regeneration with rapid re-epithelialization and ordered neovascularization. ERegen-gel produced a soft, basket-weave extracellular matrix and robust regeneration of skin appendages resembling unwounded skin. Mechanistically, it attenuated Piezo1/YAP mechanosignaling in macrophages, promoting M2 polarization and a pro-regenerative immune microenvironment. 2

Vasculogenic tissue nanotransfection enhances recovery after long-segment peripheral nerve repair

Vasculogenic tissue nanotransfection (TNT) nonvirally reprograms local cells in situ toward a vasculogenic phenotype to support peripheral nerve regeneration. An optimized Etv2–Fli1–Foxc2 gene cocktail maximized vasculogenic reprogramming efficiency. In a long-segment nerve defect repaired with isografts, TNT markedly improved grip strength and muscle contractility versus control grafts. TNT-treated nerves showed increased vascular density and myelinated axon counts, indicating structurally and functionally superior regeneration. 3

Early, organized vascularization underlies muscle-in-vein graft success in nerve repair

This rat median nerve study examined muscle-in-vein (MIV) grafts across early regeneration time points. An 8 mm nerve gap repaired with MIV showed complete macrophage infiltration and well-organized vascularization by day 7. RNA sequencing identified enrichment of vascular development pathways and key angiogenesis-related genes within the graft. Partial anastomosis formed between vessels from nerve stumps and those within the muscle component, suggesting synergistic vascular contributions from muscle and vein. 4