Edson Paulo Macías Mendieta

Regenerative dermatology has emerged as a transformative field that integrates advances in regenerative medicine, molecular biology, and aesthetic dermatology to promote tissue repair through biological rather than purely corrective mechanisms. Among the most promising innovations, exosomes and polynucleotides have attracted considerable scientific attention because of their ability to stimulate fibroblast activity, enhance collagen synthesis, regulate inflammatory responses, promote angiogenesis, and improve extracellular matrix remodeling. The objective of this review was to analyze the current scientific evidence regarding the biological foundations, clinical applications, therapeutic effectiveness, safety profile, and future perspectives of these next-generation regenerative therapies. A narrative literature review was conducted following the scientific method using peer-reviewed publications from major biomedical databases. The available evidence demonstrates encouraging results in facial rejuvenation, photoaging, scar remodeling, chronic wound healing, periocular rejuvenation, and hair restoration, with improvements in skin quality and high patient satisfaction while maintaining a favorable short-term safety profile. Nevertheless, important methodological limitations remain, including heterogeneous treatment protocols, limited randomized clinical trials, and insufficient long-term follow-up. Continued international collaboration, standardized manufacturing processes, rigorous regulatory frameworks, and high-quality multicenter clinical studies will be essential to establish evidence-based therapeutic guidelines and consolidate regenerative dermatology as a mature clinical discipline.

Enhanced Recovery After Surgery (ERAS) has become a fundamental approach in contemporary perioperative medicine by integrating multidisciplinary, evidence-based interventions designed to reduce surgical stress, accelerate functional recovery, and improve clinical outcomes. This review analyzed current scientific evidence regarding the physiological foundations, perioperative components, clinical effectiveness, and international implementation of ERAS protocols across different surgical specialties. Relevant literature was examined from major biomedical databases and international clinical guidelines, prioritizing clinical practice guidelines, systematic reviews, meta-analyses, clinical studies, and consensus documents addressing enhanced recovery and perioperative care. The evidence reviewed indicates that ERAS pathways are associated with reductions in postoperative complications and hospital length of stay, earlier restoration of gastrointestinal function and mobility, decreased opioid requirements, and more efficient utilization of healthcare resources. Favorable outcomes were observed across colorectal, hepatobiliary, pancreatic, thoracic, gynecologic, urologic, orthopedic, and other surgical fields, although their magnitude varied according to procedure complexity, patient characteristics, institutional resources, and protocol adherence. Greater compliance with ERAS components was consistently associated with better postoperative outcomes, emphasizing the importance of multidisciplinary collaboration, standardized clinical pathways, professional education, and continuous quality improvement. Despite persistent implementation barriers, particularly in resource-constrained healthcare systems, the principles of enhanced recovery can be adapted to different institutional environments, including those in Latin America. ERAS therefore represents an evolving model of evidence-based surgical care capable of improving patient safety, functional recovery, and healthcare efficiency. Future developments involving personalized perioperative medicine, digital monitoring, predictive analytics, and emerging technologies may further strengthen enhanced recovery pathways and support their broader implementation worldwide.

The integration of artificial intelligence (AI), wearable technologies, and digital health monitoring systems has significantly transformed modern healthcare by enabling continuous patient surveillance, personalized interventions, and improved access to medical services. Despite these advances, increasing evidence suggests that prolonged use of wearable devices may be associated with a variety of cutaneous manifestations that can affect patient comfort, treatment adherence, and overall healthcare outcomes. This review aimed to analyze the current scientific evidence regarding dermatological complications associated with wearable technologies, biosensors, adhesive monitoring systems, and AI-assisted healthcare platforms. A qualitative integrative review was conducted using the Scientific Method as a methodological framework. Scientific literature was identified through searches in PubMed/MEDLINE, Scopus, ScienceDirect, Web of Science, and Google Scholar. Evidence related to dermatological manifestations, immunological mechanisms, clinical implications, artificial intelligence applications, and preventive strategies was critically evaluated and synthesized. The findings indicate that allergic contact dermatitis, irritant contact dermatitis, medical adhesive-related skin injuries, erythema, pruritus, and pressure-associated lesions are the most frequently reported complications. Pathophysiological mechanisms involve adhesive exposure, epidermal barrier disruption, mechanical friction, humidity accumulation, and delayed hypersensitivity reactions. Artificial intelligence demonstrated considerable potential for lesion classification, teledermatology support, remote monitoring, and predictive risk assessment. The review concludes that while wearable technologies and AI provide substantial healthcare benefits, their successful implementation requires greater attention to dermatological safety, patient-centered device design, interdisciplinary collaboration, and preventive strategies aimed at minimizing cutaneous adverse effects.

Precision medicine has progressively transformed anesthesiology by promoting individualized perioperative management based on biological, physiological, and technological information. Within this context, biomarker-guided anesthesia and real-time metabolic monitoring have emerged as promising approaches for improving patient safety, optimizing anesthetic interventions, and enhancing clinical outcomes in surgical and critically ill populations. This review analyzed current scientific evidence regarding the role of biomarkers, advanced physiological monitoring technologies, pharmacogenomics, artificial intelligence, and metabolic surveillance systems in precision anesthesia. A comprehensive review of the literature published between 2009 and 2025 was conducted using major biomedical databases, including PubMed/MEDLINE, Scopus, Web of Science, ScienceDirect, SpringerLink, Wiley Online Library, and the Cochrane Library. The findings demonstrated increasing utilization of cardiovascular and metabolic biomarkers, electroencephalographic monitoring, near-infrared spectroscopy, continuous glucose monitoring, lactate surveillance, advanced hemodynamic assessment, and artificial intelligence-supported decision systems. Collectively, these technologies contributed to improved risk stratification, earlier detection of physiological deterioration, optimization of anesthetic drug administration, enhanced postoperative recovery, and reduction of perioperative complications. The evidence also indicated that multimodal monitoring strategies consistently outperform isolated monitoring approaches by providing a more comprehensive representation of patient physiology. Furthermore, artificial intelligence and automated monitoring platforms showed significant potential for improving predictive accuracy and individualized clinical decision-making. Overall, biomarker-guided precision anesthesia and real-time metabolic monitoring represent transformative developments in perioperative and critical care medicine. The integration of biological indicators, advanced monitoring technologies, and data-driven clinical strategies supports a more personalized approach to anesthetic management and may contribute to safer, more effective, and outcome-oriented patient care. Continued research and technological standardization will be essential to facilitate broader implementation of precision anesthesia within future healthcare systems.