Postoperative Complications’ Correlations With Clinical and Laboratory Indicators, Molecular and Genetic Markers: Cohort Study
Year: 2026
Type: article
Study design: Observational Study
Abstract: Plastic and reconstructive surgery is essential for restoring structural integrity, functional capacity, and aesthetic appearance. But, biological mechanisms underlying possible postoperative complications and wound healing are underestimated. The aim of the study: to investigate the correlations between the postoperative complications with some clinical- laboratory and molecular- genetic markers of wound healing after plastic and reconstructive surgical interventions. Material and Methods. A total of 95 women were enrolled in this prospective longitudinal cohort study and underwent reconstructive/plastic surgery. The mean age was 35.48±6.61 years (range 19-57). All participants received comprehensive clinical, demographic, laboratory, and instrumental assessments. The study complied with GCP standards and the Council of Europe Convention on Human Rights and Biomedicine. Gene transcription levels of IL6, CCL2, IL10, MMP9, COL1A1, COL3A1, MAPK1, and MAPK8 in peripheral blood were validated using a pathway- specific PCR array. Linkage between variables were assessed using Spearman’s or Pearson’s correlation coefficients. Results. Among the analyzed markers, MMP9, IL-10, COL1A1, and IL-6 demonstrated the strongest associations with postoperative complications, highlighting the central role of dysregulated matrix turnover and persistent inflammation (r=0.65-0.99; p≤0.04-0.001). Elevated MMP9 expression likely reflects excessive ECM degradation, while increased COL1A1 expression indicates enhanced fibrotic activity. The coexistence of these processes suggests an imbalance between collagen synthesis and degradation, a mechanism known to contribute to pathological healing, including fibrosis, capsular contracture, and impaired tissue integrity. Notably, very high correlations between IL-6 and IL-10 (r≈0.95) and between MAPK1 and IL-6 (r≈0.99) point to a synchronized activation of inflammatory and intracellular signaling pathways. The strongest mechanistic axis leading to complications appears to be: IL-6 / MAPK → COL1A1 / COL3A1 → MMP9 → postoperative complications. Conclusions. Strong correlations observed between IL-6, IL-10, MAPK1/MAPK8, and collagen- related genes (COL1A1, COL3A1) indicate coordinated regulation of immune responses and fibrogenesis rather than independent pathway activation in wound healing after plastic and reconstructive surgery.
Institution: Bukovinian State Medical University
Language: English
Topic: Wound Healing and Treatments
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7204175987