The current state of knowledge on how to improve skin flap survival: A review

Afrooghe, Arya; Damavandi, Amirmasoud Rayati; Ahmadi, Elham; Jafari, Razieh Mohammad; Dehpour, Ahmad Reza

doi:10.1016/j.bjps.2023.04.021

Cited by 11 publications

(1 citation statement)

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“…Intraoperative techniques include the use of vessel supercharging techniques or intraoperative preconditioning. Postoperative ischemia treatment may be addressed by hyperbaric oxygen treatment, local vasodilator application, or topical growth factor treatment [ 3 , 4 ]. Although such interventions can provide short-term increases in vessel density in flap surroundings, they require repetitive administration (except surgical delay) and strongly depend on accessibility to the affected flap tissue.…”

Section: Introductionmentioning

confidence: 99%

VEGF and Other Gene Therapies Improve Flap Survival—A Systematic Review and Meta-Analysis of Preclinical Studies

Paskal,

Gotowiec,

Stachura

et al. 2024

IJMS

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Surgical flaps are basic tools in reconstructive surgery. Their use may be limited by ischemia and necrosis. Few therapies address or prevent them. Genetic therapy could improve flap outcomes, but primary studies in this field present conflicting results. This systematic review and meta-analysis aimed to appraise the efficacy of external gene delivery to the flap for its survival in preclinical models. This review was registered with PROSPERO (CRD42022359982). PubMed, Embase, Web of Science, and Scopus were searched to identify studies using animal models reporting flap survival outcomes following any genetic modifications. Random-effects meta-analysis was used to calculate mean differences in flap survival with accompanying 95% CI. The risk of bias was assessed using the SYRCLE tool. Subgroup and sensitivity analyses were performed to ascertain the robustness of primary analyses, and the evidence was assessed using the GRADE approach. The initial search yielded 690 articles; 51 were eventually included, 36 of which with 1576 rats were meta-analyzed. VEGF gene delivery to different flap types significantly improved flap survival area by 15.66% (95% CI 11.80–19.52). Other interventions had smaller or less precise effects: PDGF—13.44% (95% CI 3.53–23.35); VEGF + FGF—8.64% (95% CI 6.94–10.34); HGF—5.61% (95% CI 0.43–10.78); FGF 3.84% (95% CI 1.13–6.55). Despite considerable heterogeneity, moderate risk of bias, and low quality of evidence, the efficacy of VEGF gene therapy remained significant in all sensitivity analyses. Preclinical data indicate that gene therapy is effective for increasing flap survival, but further animal studies are required for successful clinical translation.

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Section: Introductionmentioning

confidence: 99%

VEGF and Other Gene Therapies Improve Flap Survival—A Systematic Review and Meta-Analysis of Preclinical Studies

Paskal,

Gotowiec,

Stachura

et al. 2024

IJMS

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The Future of Biohybrid Regenerative Bioelectronics

Carnicer‐Lombarte,

Malliaras,

Barone

2024

Advanced Materials

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Biohybrid regenerative bioelectronics are an emerging technology combining implantable devices with cell transplantation. Once implanted, biohybrid regenerative devices integrate with host tissue. The combination of transplant and device provides an avenue to both replace damaged or dysfunctional tissue, and monitor or control its function with high precision. While early challenges in the fusion of the biological and technological components limited development of biohybrid regenerative technologies, progress in the field has resulted in a rapidly increasing number of applications. In this perspective the great potential of this emerging technology for the delivery of therapy is discussed, including both recent research progress and potential new directions. Then the technology barriers are discussed that will need to be addressed to unlock the full potential of biohybrid regenerative devices.

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