Role of exosome therapy in reconstructive surgery: a review.

Relatively higher-quality human studies compared with other topics in this database, e.g. multiple RCTs or systematic reviews. This does not mean it is standard or approved care.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Introduction Exosomes are nanosized extracellular vesicles that facilitate intercellular communication through their diverse molecular cargo, including proteins, microRNAs, and lipids. By modulating inflammation, angiogenesis, and extracellular matrix remodeling, exosomes have emerged as promising therapeutic agents in plastic and reconstructive surgery. Understanding source-specific characteristics, isolation methods, and delivery strategies is crucial to optimize their clinical translation. Methods This review employed a review approach, integrating preclinical and clinical evidence to provide a comprehensive overview of exosome biology, sources, isolation techniques, delivery modalities, and therapeutic applications. Emphasis was placed on highlighting mechanistic insights, translational relevance, and comparative analyses of different exosome sources and delivery strategies. The methodology prioritized thematic organization and qualitative integration over quantitative meta-analysis to capture the breadth of current knowledge and emerging trends in regenerative and reconstructive surgery. Results Adipose-derived stem cell (ADSC) exosomes provided high yields with strong angiogenic and anti-fibrotic effects, whereas bone marrow MSC (BM-MSC) and dermal fibroblast exosomes primarily contributed immunomodulatory and extracellular matrix regulatory functions. Umbilical cord MSC

Evidence level

Relatively higher-quality human studies compared with other topics in this database, e.g. multiple RCTs or systematic reviews. This does not mean it is standard or approved care.

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