Department of Methodology, Medical University of Warsaw, 1b Banacha Street, 02-091 Warsaw, Poland.
Doctoral School, Medical University of Warsaw, 81 Żwirki i Wigury Street, 02-091 Warsaw, Poland.
Int J Mol Sci. 2024 Sep 25;25(19):10330. doi: 10.3390/ijms251910330.
Surgical flaps are rudimentary tools in reconstructive surgery, especially following extensive solid tumour resections. They cover skin and soft tissue defects but are prone to ischaemia and necrosis. Since their primary aim is reconstruction, they rarely exhibit a therapeutic activity against the treated disease. Attempts have been made to develop a new therapeutic strategy-biologic brachytherapy, which uses genetically engineered surgical flaps as a drug delivery vehicle, allowing the flap tissue to act as a "biologic pump". This systematic review summarizes the preclinical evidence on using genetically modified surgical flaps. A literature search was conducted in PubMed, EMBASE, Scopus and Web of Science. The initial literature search yielded 714 papers, and, eventually, seventy-seven studies were included in qualitative analysis. The results show that genetic enhancement of flaps has been used as a local or systemic therapy for numerous disease models. Frequently, it has been used to increase flap survival and limit ischaemia or promote flap survival in a non-ischemic context, with some studies focusing on optimizing the technique of such gene therapy. The results show that genetically modified flaps can be successfully used in a variety of contexts, but we need more studies to implement this research into specific clinical scenarios.
外科皮瓣是重建外科中的基本工具，特别是在广泛的实体瘤切除术后。它们覆盖皮肤和软组织缺损，但容易发生缺血和坏死。由于其主要目的是重建，因此它们很少对治疗疾病表现出治疗活性。人们试图开发一种新的治疗策略——生物近距离放射治疗，该治疗方法使用基因工程外科皮瓣作为药物输送载体，使皮瓣组织充当“生物泵”。本系统评价总结了使用基因修饰外科皮瓣的临床前证据。在 PubMed、EMBASE、Scopus 和 Web of Science 中进行了文献检索。最初的文献检索产生了 714 篇论文，最终有 77 项研究纳入定性分析。结果表明，皮瓣的基因增强已被用作多种疾病模型的局部或全身治疗。通常，它被用于增加皮瓣存活率并限制缺血，或在非缺血情况下促进皮瓣存活，一些研究侧重于优化这种基因治疗的技术。结果表明，基因修饰的皮瓣可以在多种情况下成功使用，但我们需要更多的研究将这项研究应用于特定的临床情况。
