Advanced Tissue Regeneration Using Biomaterials, Growth Factors, and Reconstructive Surgery in Patients with Massive Soft Tissue Loss Secondary to Complex Trauma: A Case Report with Systematic Review and Proposal for New Research Directions
DOI:
https://doi.org/10.70577/asce.v5i3.985Keywords:
Tissue regeneration; biomaterials; growth factors; complex trauma; soft tissue loss; reconstructive surgery; decellularized extracellular matrix; extracellular vesicles.Abstract
Massive soft tissue loss secondary to complex trauma represents one of the most formidable challenges in reconstructive surgery. Conventional approaches, based on autologous flaps and dermal substitutes, present inherent limitations including donor-site morbidity, tissue scarcity, and suboptimal functional and aesthetic outcomes. Advanced tissue regeneration, through the integration of smart biomaterials, growth factors, and reconstructive surgical techniques, emerges as a transformative paradigm. We present the case of a 30-year-old male with massive soft tissue loss of the lower limb secondary to a high-energy motor vehicle accident, who refused conventional radical debridement. A tissue engineering-based reconstructive approach was implemented, combining precise conservative debridement, platelet-rich plasma (PRP) injection, modified negative pressure wound therapy, and application of an absorbable polyurethane matrix biomaterial. At 6 months, the patient presented a mature and flexible grafted area with full range of motion and complete functional recovery, with satisfaction scores of 10/10. A systematic search was performed in PubMed, Scopus, and Web of Science up to May 2026, following PRISMA guidelines. A total of 61 studies (8,742 patients) addressing the use of biomaterials (dermal matrices, hydrogels, nanofibers, decellularized adipose matrices), growth factors (VEGF, PDGF, FGF, PRP, PRF), and reconstructive techniques (microvascularized flaps, cell therapy, bioprinting) in traumatic soft tissue defects were included. The evidence suggests that the combination of biocompatible scaffolds with controlled-release growth factors and vascularized flap coverage enhances tissue integration and regeneration quality. Advanced tissue regeneration constitutes a rapidly evolving field with transformative potential for managing post-traumatic massive soft tissue loss. The integration of biomaterials, growth factors, and reconstructive surgical techniques offers promising outcomes, as illustrated by the presented case. Clinical trials are needed to validate these strategies and establish evidence-based therapeutic algorithms
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Copyright (c) 2026 Mario Daniel Hidalgo Flores , Sophia Beatriz Cárdenas Verdezoto , Mateo Sebastián Moya Artieda , Dayane Pamela Benites Panchi , Dayssi Marisol Masabanda Chinchero
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