Genetic Modulation of Wound Healing Pathways and Postoperative Risk in Plastic and Reconstructive Surgery: A Cohort...

Area of Science:

• Molecular biology
• Plastic surgery
• Genetics

Background:

• Postoperative complications in plastic surgery can significantly impact patient outcomes.
• Understanding the molecular mechanisms underlying wound healing is crucial for risk stratification.
• Age is a known factor influencing surgical outcomes, but molecular correlates require further investigation.

Purpose of the Study:

• To investigate the mRNA expression of key genes (IL-6, CCL2, IL-10, MAPK1, MAPK8, MMP9, COL1A1, COL3A1, TGFB1) in relation to adverse postoperative outcomes.
• To assess the association between gene expression patterns and patient age.
• To develop and validate a molecular risk index for predicting complications.

Main Methods:

• Prospective longitudinal cohort study of 95 women undergoing reconstructive/plastic surgery.
• mRNA expression analysis of specified genes in peripheral blood leukocytes using RT-PCR.
• Development and validation of the Molecular Complication Risk Index (MCRI) and ROC analysis.

Main Results:

• Elevated mRNA expression of IL-6, COL3A1, CCL2, MAPK1, MAPK8, IL-10, MMP9, and COL1A1 were significantly associated with increased risk of postoperative complications.
• COL1A1 overexpression showed the strongest association, increasing complication risk by 58.33-fold.
• The MCRI model demonstrated good discriminative ability (AUC = 0.78) and identified women aged ≥ 40 years as having an unfavorable molecular profile.

Conclusions:

• Transcriptional activity of the studied genes is linked to postoperative wound healing risk.
• Women over 40 years old face the highest risk of complications.
• The MCRI model can aid in early identification of high-risk patients for targeted interventions and personalized surgical planning.