Role of Immunomodulators in Reducing Postoperative Inflammation in Facial Reconstructive Surgery
DOI:
https://doi.org/10.63682/jns.v14i32S.7956Keywords:
Facial reconstructive surgery, immunomodulators, postoperative inflammation, corticosteroids, wound healing, CRP, IL-6Abstract
Background: Reconstructive surgery on the face routinely provokes a strong inflammatory reaction that slows wound healing and raises the likelihood of complications. Surgeons have therefore turned to immunomodulating agents to tame this response, yet the supporting clinical evidence remains sparse. This study aimed to evaluate the effectiveness of immunomodulators in reducing inflammation and improving recovery outcomes following facial reconstructive surgery.
Methods: Between January 2023 and January 2024, a prospective comparative study at Burns and Plastic Surgery Center Hayatabad, enrolling 61 subjects who received facial reconstructive surgery. Participants were allocated to two cohorts: those treated with immunomodulatory medication (Group A, n=31) and a control group that received standard care alone (Group B, n=30). Investigators recorded and statistically analyzed postoperative inflammation markers, clinical signs, wound healing duration, and any post-surgical complications.
Results: Patients in Group A demonstrated significantly lower CRP, WBC, and IL-6 levels within 24 hours postoperatively (p < 0.01). They also exhibited reduced facial swelling, faster wound healing, and fewer infections compared to the control group. Hospital stay was shorter in the immunomodulator group (p < 0.001). No serious adverse events were associated with immunomodulator use.
Conclusion: The use of immunomodulators, particularly corticosteroids, appears to effectively reduce inflammation and support better recovery in facial reconstructive surgery. Their inclusion in perioperative management protocols may improve both clinical outcomes and patient satisfaction..
Downloads
Metrics
References
Kim, S.-G., Immunomodulation for maxillofacial reconstructive surgery. Maxillofacial Plastic and Reconstructive Surgery, 2020. 42: p. 1-9.
Aldhabaan, S.A., J.Y. Hudise, and A.A. Obeid, A meta-analysis of pre-and postoperative corticosteroids for reducing the complications following facial reconstructive and aesthetic surgery. Brazilian Journal of Otorhinolaryngology, 2022. 88(01): p. 63-82.
Юсупова, Д., Б. Джураев, and С. Абдурахмонов, Changes of hemostatic bed parameters in the healing process postoperative facial scar. in Library, 2021. 21(4): p. 477-483.
Coelho Cavalcante, M.C., et al., Nutraceutical Immunomodulation on Acute Inflammation by Abdominal Plastic Surgery. Journal of Pharmaceutical Negative Results, 2021. 12(1).
Dong, J., et al., Immunomodulatory biomaterials for implant-associated infections: from conventional to advanced therapeutic strategies. Biomaterials Research, 2022. 26(1): p. 72.
Bense, F., et al., Syngeneic transplantation of rat olfactory stem cells in a vein conduit improves facial movements and reduces synkinesis after facial nerve injury. Plastic and Reconstructive Surgery, 2020. 146(6): p. 1295-1305.
Cushing, K. and P.D. Higgins, Management of Crohn disease: a review. Jama, 2021. 325(1): p. 69-80.
Homer, N.A., et al., 5-Fluorouracil With Microneedling Modulates Wound Healing in a Murine Model: An Immunohistochemical Analysis of Mechanism and Dose Efficacy. Ophthalmic Plastic & Reconstructive Surgery, 2022. 38(6): p. 596-601.
Qiu, H., et al., Prospective application of exosomes derived from adipose‐derived stem cells in skin wound healing: a review. Journal of cosmetic dermatology, 2020. 19(3): p. 574-581.
Almeida, I.R., et al., The role of negative pressure wound therapy (NPWT) on the treatment of pyoderma gangrenosum: a systematic review and personal experience. Wound Repair and Regeneration, 2021. 29(3): p. 486-494.
El Omari, M., et al., Adipose tissue grafting for the treatment of morphea en coup de sabre: a simple filler or an emerging cellular therapy? Cureus, 2022. 14(10).
Feng, C.-J., et al., Intra-arterial injection of human adipose-derived stem cells improves viability of the random component of axial skin flaps in nude mice. Journal of Plastic, Reconstructive & Aesthetic Surgery, 2020. 73(3): p. 598-607 DOI: https://doi.org/10.1016/j.bjps.2019.10.001.
Schoenbrunner, A.R. and J.E. Janis, Pain Management in Plastic Surgery. Clinics in Plastic Surgery, 2020. 47(2): p. 191-201 DOI: 10.1016/j.cps.2019.12.001.
Morris, J.L., et al., Comparison of intra-articular administration of adenosine, lidocaine and magnesium solution and tranexamic acid for alleviating postoperative inflammation and joint fibrosis in an experimental model of knee arthroplasty. Journal of Orthopaedic Surgery and Research, 2021. 16(1): p. 726 DOI: 10.1186/s13018-021-02871-y.
Firriolo, J.M., A. Condé-Green, and L.L.Q. Pu, Fat Grafting as Regenerative Surgery: A Current Review. Plastic and Reconstructive Surgery, 2022. 150(6).
Jeon, S., et al., The Immunomodulatory Effect of Adipose-Derived Stem Cells in Xenograft Transplantation Model. Transplantation Proceedings, 2022. 54(8): p. 2388-2395 DOI: https://doi.org/10.1016/j.transproceed.2022.06.007.
Gupta, A.A., et al., Comparative efficacy of bromelain and aceclofenac in limiting post-operative inflammatory sequelae in surgical removal of lower impacted third molar: a randomized controlled, triple blind clinical trial. J Dent Anesth Pain Med, 2022. 22(1): p. 29-37 DOI: 10.17245/jdapm.2022.22.1.29.
De Paz, D., et al. The Mandible Ameliorates Facial Allograft Rejection and Is Associated with the Development of Regulatory T Cells and Mixed Chimerism. International Journal of Molecular Sciences, 2021. 22, DOI: 10.3390/ijms222011104.
Wassmer, C.-H. and E. Berishvili, Immunomodulatory Properties of Amniotic Membrane Derivatives and Their Potential in Regenerative Medicine. Current Diabetes Reports, 2020. 20(8): p. 31 DOI: 10.1007/s11892-020-01316-w.
Egro, F.M. and S.R. Coleman, Facial Fat Grafting: The Past, Present, and Future. Clinics in Plastic Surgery, 2020. 47(1): p. 1-6 DOI: 10.1016/j.cps.2019.08.004.
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
Terms:
- Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
