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The Top 100 Most Cited Articles in Reconstructive Microsurgery: Identifying Evidence Gaps and Research Trends for
Hatan Mortada1,2, Mustafa Qais Al-Khafaji3, Zainalabden E Jefri4
1Division of Plastic Surgery, Department of SurgeryKing Saud University Medical CityRiyadh, Riyadh ProvinceSaudi Arabia.
Background:
Reconstructive microsurgery restores form and function after trauma, oncological resection, or congenital deformities. This study provides a bibliometric analysis of the most cited articles, identifies evidence gaps, and proposes future research priorities.
Methods:
The top 100 most cited articles were retrieved from Scopus on January 1, 2025, and analyzed for publication trends, authorship, themes, and impact metrics using VOSviewer and R Bibliometrix.
Results:
From 57,925 articles, the top 100 were selected (mean citations: 251.99 ± 207.78), predominantly in Q1 journals. Head and neck reconstruction dominated (49.5%). Hidalgo D.A. was the most frequent author, and the United States contributed nearly half of all articles. Most provided Level III-IV evidence (38.14% each); none met Level I criteria. Annual citation rates increased from 6.87 (1970s) to 16.32 (2010s). Four evolutionary phases were identified: Technical feasibility, clinical refinement, evidence-based optimization, and emerging interdisciplinary standardization.
Conclusions:
Three critical findings emerged: (1) No Level I studies and only 7.22% Level II evidence; (2) geographic concentration, with nearly half of contributions from the United States; and (3) a thematic shift from anatomical descriptions toward outcomes research. These findings provide a roadmap for advancing the field.