Topic: Precision Repair and Functional Reconstruction of Complex Wounds: From Mechanistic Insights to Clinical Translation

Aim of the Special Topic

The management of complex wounds requires more than wound closure; restoration of tissue integrity, function, and long-term quality of life is equally important. This Special Topic aims to highlight emerging scientific and clinical advances in complex wound repair and reconstruction, including modulation of the wound microenvironment, tissue regeneration, infection control, vascular and neural reconstruction, regenerative medicine, microsurgery, and digitally assisted precision treatment. By integrating basic research, translational medicine, and clinical practice, this collection seeks to improve our understanding of the mechanisms underlying impaired wound healing and functional tissue loss, accelerate the translation of innovative therapeutic and reconstructive strategies, and promote more precise, individualized, and function-oriented approaches to complex wound management.

Special Topic Introduction

Complex wounds remain a major challenge in plastic and reconstructive surgery. Trauma, burns, diabetes, infection, vascular disorders, radiation injury, and oncologic resection can result in extensive skin and soft-tissue defects with markedly different biological and clinical characteristics. In large, chronic, or anatomically complex wounds, achieving wound closure alone is often insufficient. Restoring tissue architecture, vascularity, sensation, mobility, appearance, and ultimately patient quality of life has therefore become an increasingly important goal of modern wound repair and reconstructive surgery.

Recent advances are shifting the field from conventional wound healing toward precision regulation and functional regeneration. Single-cell sequencing, spatial omics, and other multi-omics technologies are providing unprecedented insights into cellular heterogeneity and the dynamic wound microenvironment. Immune regulation, cellular senescence, angiogenesis, neural regeneration, extracellular matrix remodeling, and mechanobiology have emerged as important mechanistic areas of investigation. At the same time, stem cells and extracellular vesicles, bioactive and smart biomaterials, tissue engineering, three-dimensional bioprinting, targeted drug delivery, and negative-pressure wound therapy are expanding the therapeutic options available for difficult-to-heal wounds. Continued progress in microsurgery, perforator flaps, free tissue transfer, and other reconstructive techniques has further improved the possibility of restoring both form and function after complex tissue loss.

Digital technologies are also beginning to reshape wound care and reconstruction. Artificial intelligence, quantitative imaging, computer-assisted planning, and predictive models offer new opportunities for objective wound assessment, individualized treatment selection, reconstructive planning, and longitudinal outcome monitoring. Nevertheless, important challenges remain, including biological heterogeneity among wound types, optimal timing of intervention, long-term functionality of regenerated tissues, standardization of outcome assessment, and the safety and reproducibility of emerging therapies.

This Special Topic, “Precision Repair and Functional Reconstruction of Complex Wounds: From Mechanistic Insights to Clinical Translation,”welcomes original research, reviews, perspectives, clinical studies, and technical innovations addressing these challenges. By bringing together advances in wound biology, regenerative medicine, biomaterials, microsurgery, and digital medicine, we hope to strengthen the connection between mechanistic discovery and clinical need and to promote a transition from simple wound closure toward tissue regeneration, functional restoration, and improved long-term patient outcomes