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A bibliometric review identified the 100 most-cited flap reconstruction imaging articles from Web of Science (1950–2024), extracting citation counts, subject areas, imaging types, outcome measures, and evidence levels. Highly cited work aggregated 21,619 patients and 9689 citations, dominated by retrospective cohorts and case series (levels 3–4). Randomized evidence was rare, and validated patient-reported outcomes were scarcely reported. Imaging-focused results emphasized preoperative planning over cost-effectiveness or intra/postoperative perfusion assessment. Key influential studies were largely single-center and non-randomized.",{"@graph":69,"@context":126},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/reconstructive-trends-in-imaging-studies-for-flap-reconstruction-surgery-a-bibliometric-analysis/452697/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/reconstructive-trends-in-imaging-studies-for-flap-reconstruction-surgery-a-bibliometric-analysis/452697.png","ImageObject",300,407,{"name":92,"@type":93},"anakgang17","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":39},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118,122],{"name":109,"@type":110,"acceptedAnswer":111},"What was the main purpose of the bibliometric analysis?","Question",{"text":112,"@type":113},"To characterize emerging trends in imaging studies for flap reconstruction and evaluate the methodological quality of the field.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How were the articles selected and what time range was used?",{"text":117,"@type":113},"The 100 most-cited articles were identified on Web of Science across all available journals and years from 1950 to 2024.",{"name":119,"@type":110,"acceptedAnswer":120},"What evidence level dominated the research base?",{"text":121,"@type":113},"Evidence relied heavily on level 3 and level 4 studies, reflecting the prevalence of retrospective cohorts and case series, with only one randomized trial (level 1).",{"name":123,"@type":110,"acceptedAnswer":124},"Which imaging modalities and study aims were most frequently reported?",{"text":125,"@type":113},"Computed tomography angiography, Doppler ultrasound, and indocyanine green (ICG) angiography were most common. Imaging was used most often for preoperative flap planning, with fewer studies addressing intraoperative and postoperative perfusion assessment and complication detection.","https://schema.org",{"og:url":83,"og:type":128,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":130,"canonical":83},"index,follow",{"doc_id":132,"site_id":62},452697,1790792107,{"code":4,"msg":5,"data":135},{"doc_id":132,"user_id":136,"nickname":92,"user_avatar":137,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":138,"file_id":139,"file_url":140,"file_type":141,"file_size":142,"view_count":39,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":143,"language":144,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":145,"faqs":146,"seo_title":147,"seo_description":67,"update_tm":148,"read_time":149,"preview_page_count":4},962090883568,"https://ap-avatar.wpscdn.com/davatar_a8503ba1806abce46bf441b54a3ca4cd","ORiginal aRticle   \nReconstructive  \nTrends in Imaging Studies for Flap Reconstruction Surgery: A Bibliometric Analysis  \nMohammad Alzaid*† Fatema Aftab, MBChB (Commendation)‡ Ibrahim Riaz, BSc, MBBS§ Gul Rukh Khan, MBBS¶ Yvonne Tsitsiou, MBBS, BSc (Hons), MSc (Dist)∥  \nHamid Reza Khademi Mansour** Ankur Khajuria, BSc (Hons), MBBS (Dist.), FHEA, FRSPH, MRCS, MAcadMEd, MFSTEd, MSc (Oxford), PhD††  \nBackground: Imaging studies have become indispensable tools in the perforator flap surgeon’s armamentarium, significantly enhancing operative outcomes and reducing complications. We conducted the first bibliometric analysis on imaging studies for flap reconstruction to characterize any emerging trends and assess the methodological quality of the field.  \nMethods: The 100 most-cited articles in imaging studies for flap reconstruction were identified on Web of Science, across all available journals and years (1950– 2024) . Study details, including the citation count, main subject, outcome measures, imaging type, and evidence level, were extracted.  \nResults: The most-cited articles involved 21,619 patients and amassed a total of 9689 citations. Citations per article ranged from 41 to 302. The evidence base relied heavily on level 3 (n = 37) and level 4 (n = 34) studies, reflecting the prevalence of retrospective cohorts and case series. Only 1 study was a randomized trial achieving level 1 evidence. Validated patient-reported outcome measures were reported in only 1 study. Imaging outcomes were the most explored, followed by flap anatomy and comparisons of imaging modality, with cost-effectiveness being the least investigated. Imaging was most frequently used for preoperative flap planning (n = 62), with fewer studies using intraoperative (n = 27) and postoperative (n = 19) imaging for perfusion assessment and complication detection. Computed tomography angiography, Doppler ultrasound, and indocyanine green ICG angiography were the most frequently used imaging modalities.  \nConclusions: The most influential studies lacked randomization and were conducted by single-center efforts. Promoting global collaboration and incorporating patient-reported outcome measures into high-quality research can advance a more patient-centered, holistic evaluation of reconstructive success. (Plast Reconstr Surg Glob Open 2026;14:e7388; doi: 10.1097/GOX.0000000000007388; Published online 6January 2026.)  \nFrom the *School of Medicine, The University of Manchester, Manchester, United Kingdom; †Faculty of Medicine, Imperial College London, White City Campus, London, United Kingdom; ‡Department of Radiolgy, Cambridge University Hospitals, Cambridge, United Kingdom;  \n§Department of Acute Medicine, Basildon University Hospital, Basildon, United Kingdom; ¶Emergency Medicine, Watford General Hospital, Hertfordshire, United Kingdom; ∥Department of Radiology, Imperial College Healthcare NHS Trust, London, United Kingdom; **Faculty of Life Sciences and Medicine, Kings College London, London, United Kingdom; and ††Department of Plastic Surgery, Imperial College Healthcare NHS Trust, London, United Kingdom.  \nReceived for publication January 9, 2025; accepted October 8, 2025. Presented as an oral contribution at the XIII Congress of the World Society for Reconstructive Microsurgery, from April 23 to 26, 2025, held in Barcelona, Spain.  \nThe datasets generated and analyzed during the current study are available from the corresponding author on reasonable request. Copyright © 2026 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.  \nDOI: 10. 1097/GOX.0000000000007388  \nINTRODUCTION  \nFl","cbCaih5XkfjUirzN","https://ap.wps.com/l/cbCaih5XkfjUirzN","pdf",995512,11,"English","# Background\n# Methods\n# Results\n# Conclusions\n# Introduction","[{\"question\":\"What was the main purpose of the bibliometric analysis?\",\"answer\":\"To characterize emerging trends in imaging studies for flap reconstruction and evaluate the methodological quality of the field.\"},{\"question\":\"How were the articles selected and what time range was used?\",\"answer\":\"The 100 most-cited articles were identified on Web of Science across all available journals and years from 1950 to 2024.\"},{\"question\":\"What evidence level dominated the research base?\",\"answer\":\"Evidence relied heavily on level 3 and level 4 studies, reflecting the prevalence of retrospective cohorts and case series, with only one randomized trial (level 1).\"},{\"question\":\"Which imaging modalities and study aims were most frequently reported?\",\"answer\":\"Computed tomography angiography, Doppler ultrasound, and indocyanine green (ICG) angiography were most common. Imaging was used most often for preoperative flap planning, with fewer studies addressing intraoperative and postoperative perfusion assessment and complication detection.\"}]","Reconstructive Trends in Imaging Studies for Flap Reconstruction Surgery - A Bibliometric Analysis | PDF",1790737584,28]