Advancements in pediatric tissue engineering: scaffold-based and cell-driven approaches.

Tissue engineering holds significant promise for advancing pediatric reconstructive surgery by overcoming the limitations of conventional autografts and static implants while harnessing the unique regenerative potential of developing tissues. This review aims to synthesize recent progress and ongoing challenges in pediatric tissue engineering, with a primary focus on the development, design, and clinical translation of biomaterial scaffolds. We examine how scaffold architecture, material composition, and fabrication strategies can be tailored to accommodate pediatric growth, dynamic mechanical demands, and long-term biological integration. While complementary approaches such as stem cell therapies, computational modeling, and disease-specific platforms are acknowledged, the central emphasis remains on scaffold-based solutions that address the distinct anatomical and physiological requirements of children. By moving beyond adult-centric treatment paradigms, the field is gradually shifting toward a more integrated regenerative surgery framework that prioritizes adaptive tissue remodeling and functional recovery. Ultimately, this review highlights how purpose-built scaffolds and emerging biofabrication techniques are paving the way for safer, more effective reconstructive options in pediatric care, while identifying the key translational and regulatory barriers that must be addressed to realize their full clinical potential.