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Open research questions in Reconstructive Surgery and Microvascular Techniques

126 gap statements mined from Reconstructive Surgery and Microvascular Techniques papers in our 4.5M-paper local library, which holds 1,349 papers on the topic — drawn mostly from each paper's own stated research gap, future-work, challenge and limitation notes, and its abstract. The ones listed below are a selection still marked open; each names the study that raised it, with a DOI link where the paper has one.

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What the literature leaves open

  • Secondly, the form and dose of nitroglycerin administered, as well as the interval between administration and CTA image acquisition, were not explored in depth.

    Advantages of nitroglycerin application in preoperative CTA for DIEP flap breast reconstruction · 2026 · DOI

  • Open exposure and straightening of the STA with direct puncture using a wedged PIVC provide secure access and stable catheter control when percutaneous approaches are insufficient.

    Open Straightening and Direct Puncture of the Superficial Temporal Artery for Tumor Embolization via Transosseous Feeders · 2026 · DOI

  • The study used a limited number of cadavers (seven). The data were derived from cadaveric specimens, which may not perfectly represent living tissues. Access to the full raw dataset is restricted due to ethical considerations.

    Topographical analysis of arterial perforators in the face: A cadaveric study · 2026 · DOI

  • Comprehensive anatomical data on arterial perforators in the face are limited. There is a need to investigate the number, diameter, and topographic distribution of arterial perforators in the face.

    Topographical analysis of arterial perforators in the face: A cadaveric study · 2026 · DOI

  • The reconstruction of full thickness cheek defects requires providing bulk and cover for both cheek skin and oral mucosa. The lack of resources and expertise in certain settings limits the use of free flaps, making pedicled flaps a practical alternative. The bipaddled pectoralis major myocutaneous flap has specific challenges, including difficulty in flap harvesting in women and the risk of complications.

    Reconstruction of Full Thickness Cheek Defects After Resection of Oral Malignancies in Resource Challenged Settings : Our Experience with Bipaddled Pectoralis Major Myocutaneous Flap · 2026 · DOI

  • The lack of studies on the use of the bipaddled pectoralis major myocutaneous flap in reconstructing full thickness cheek defects in resource-challenged settings. The need for more prospective studies to confirm the findings and evaluate the long-term outcomes.

    Reconstruction of Full Thickness Cheek Defects After Resection of Oral Malignancies in Resource Challenged Settings : Our Experience with Bipaddled Pectoralis Major Myocutaneous Flap · 2026 · DOI

  • There is a need to compare the outcomes of fibular and scapular osseous flaps in cervicofacial reconstruction. The effectiveness of the scapular flap as a reconstructive alternative is unknown. The factors influencing donor-site morbidity and patient-reported outcomes are not well understood.

    Clinical outcomes of fibular and scapular free osseous flaps in head and neck reconstruction: a retrospective comparative study · 2026 · DOI

  • There is a need for effective techniques for mandibular reconstruction in patients with osteoradionecrosis. Prior techniques have limitations, especially in these patients.

    RECONSTRUÇÃO MANDIBULAR COM RETALHO LIVRE DE FÍBULA: RELATO DE CASO · 2026 · DOI

  • Racial and ethnic disparities in surgical outcomes following head and neck cancer (HNC) reconstruction are well documented, but their impact on appearance-related, psychological, and functional distress remains unclear.

    Impact Of Race And Ethnicity On Patient-reported Outcomes In Head And Neck Cancer Reconstruction · 2026 · DOI

  • There is a need for effective reconstructive options for knee defects. The existing literature on reconstructive options for knee defects has several limitations.

    Outcome of Superior Lateral Genicular Artery Perforator Flap for Reconstruction of Defects Around Knee Joint, in DMCH, Bangladesh · 2026 · DOI

  • Reconstruction of short mandibular defects (< 2 cm) remains controversial, as these defects lie within a clinical “gray zone” between spontaneous healing and the need for surgical intervention.

    Sliding osteotomy for reconstruction of short post-gunshot mandibular defects < 2 cm: a prospective case series and narrative literature review · 2026 · DOI

  • Previous studies have focused on implant-associated complications and local recurrences, but have not reported on other potentially life-threatening adverse events. There is a need for a comprehensive analysis of complications following PI to PIII pelvic resections for intermediate and malignant tumors.

    Complications of PI to PIII hemipelvic resections for intermediate and malignant tumours · 2026 · DOI

  • Investigating the application of supermicrosurgery in lymphatic reconstruction; Exploring the use of emerging technologies in reconstructive microsurgery; Conducting more Level I studies to address evidence gaps.

    The Top 100 Most Cited Articles in Reconstructive Microsurgery: Identifying Evidence Gaps and Research Trends for Future Investigation — A Bibliometric and Visualization Analysis · 2026 · DOI

  • There is a need for effective reconstructive techniques for axillary defects after HS excision. The current treatment options for HS have limitations, and there is a need for reliable and effective reconstructive options.

    Thoracodorsal Artery Perforator Flap Reconstruction for Axillary Hidradenitis Suppurativa: A Case Report and Literature Review · 2026 · DOI

  • Further studies are needed to compare the OVD-assisted press injection technique to other techniques. Long-term follow-up studies are needed to assess the durability of the technique. Studies are needed to assess the efficacy and safety of the technique in patients with different types of macular holes.

    OVD-assisted press injection in gasless surgery for sectorial inverted internal limiting membrane flap stabilization · 2026 · DOI

  • There is a need for a reliable method to minimize the risk of complications in ZIP flap reconstruction. The existing literature on NIR devices has not fully explored its potential in ZIP flap reconstruction.

    Preoperative Near-Infrared (NIR) Vein Visualization in Zygomatic Implant Perforated (ZIP) Flap · 2026 · DOI

  • There is a need to document variations in the dorsalis pedis artery. The knowledge of the artery's variations is important for surgical procedures and diagnosis of vascular diseases.

    Dorsalis Pedis Artery and its Variations: A Cross-sectional Cadaveric Study · 2026 · DOI

  • Achieving optimal oral competence and aesthetic outcomes remains a challenge. Reconstruction of lower-lip defects following oncologic resection requires restoration of both aesthetics and oral competence. Larger full-thickness defects may be associated with inadequate commissural support and reduced oral competence.

    Functional and Aesthetic Outcomes of Lower-Lip Reconstruction Using Bilateral Nasolabial Flaps with an Interposed Fascia Lata Sling for Squamous Cell Carcinoma: A Case Report · 2026 · DOI

  • This report is limited by its single-case design. The follow-up period is short. Functional outcomes were assessed clinically without validated objective or quality-of-life measures.

    Functional and Aesthetic Outcomes of Lower-Lip Reconstruction Using Bilateral Nasolabial Flaps with an Interposed Fascia Lata Sling for Squamous Cell Carcinoma: A Case Report · 2026 · DOI

  • There is a need for a reliable and versatile reconstructive option for managing complex soft-tissue defects following oncological resection. The existing literature lacks a comprehensive evaluation of the pedicled ALT flap's versatility and postoperative outcomes.

    Versatility of The Pedicled Anterolateral Thigh Flap for Reconstruction After Tumor Resection · 2026 · DOI

  • There is a lack of studies reporting objective sensory outcomes and patient-reported outcome measures following breast reconstruction. Few studies have evaluated sensation, symptoms, and QoL together in unilateral reconstruction.

    Quality of Life, Breast Sensation, and Symptoms in Unilateral Breast Reconstruction with Direct Neurotization (Tommy Transfer) DIEP Free Flap: A Case Series · 2026 · DOI

  • The study had a relatively small sample size of 28 patients. The follow-up duration was limited to a maximum of 20 months. The study did not compare the OVD-assisted press injection technique to other techniques.

    OVD-assisted press injection in gasless surgery for sectorial inverted internal limiting membrane flap stabilization · 2026 · DOI

  • Identifying evidence gaps in reconstructive microsurgery; Analyzing the citation trends and research priorities in the field; Addressing the geographic concentration of contributions.

    The Top 100 Most Cited Articles in Reconstructive Microsurgery: Identifying Evidence Gaps and Research Trends for Future Investigation — A Bibliometric and Visualization Analysis · 2026 · DOI

  • Publication bias assessment using funnel plots was limited by the small number of included studies…

    Comparative Effectiveness Between Radial Forearm Flap and Pectoralis Major Myocutaneous Flap for Tongue Carcinoma Reconstruction: A Systematic Review and Meta-analysis · 2026 · DOI

  • Small sample size of 12 patients, - Limited to patients with specific types of tumors and defects, - No long-term follow-up…

    Versatility of The Pedicled Anterolateral Thigh Flap for Reconstruction After Tumor Resection · 2026 · DOI

Most-cited papers in Reconstructive Surgery and Microvascular Techniques

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Open questions raised by papers listed on this page include: (1) There is a need to investigate the number, diameter, and topographic distribution of arterial perforators in the face (“Topographical analysis of arterial perforators in the face: A cadaveric study”, 2026); (2) The lack of resources and expertise in certain settings limits the use of free flaps, making pedicled flaps a practical alternative (“Reconstruction of Full Thickness Cheek Defects After Resection of Oral…”, 2026); (3) There is a need to compare the outcomes of fibular and scapular osseous flaps in cervicofacial reconstruction (“Clinical outcomes of fibular and scapular free osseous flaps in head and neck…”, 2026); (4) There is a need for effective techniques for mandibular reconstruction in patients with osteoradionecrosis (“RECONSTRUÇÃO MANDIBULAR COM RETALHO LIVRE DE FÍBULA: RELATO DE CASO”, 2026); (5) Racial and ethnic disparities in surgical outcomes following head and neck cancer (HNC) reconstruction are well documented, but their impact on appearance-related, psychological, and functional distress remains unclear (“Impact Of Race And Ethnicity On Patient-reported Outcomes In Head And Neck…”, 2026). 126 gap statements have been mined from Reconstructive Surgery and Microvascular Techniques papers in our 4.5M-paper local library, which holds 1,349 papers on the topic; the gaps come from whichever of those papers state one. They are mostly the research gaps the authors state and the papers' abstracts, plus future-work, limitations and challenges passages. The ones listed below are a selection still marked open; each names the study that raised it, with a DOI link where the paper has one, so you can read the original claim in context.

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