{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T03:38:27Z","timestamp":1787715507746,"version":"build-2784847793"},"reference-count":39,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","jprasurg.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Journal of Plastic, Reconstructive & Aesthetic Surgery"],"published-print":{"date-parts":[[2026,7]]},"DOI":"10.1016\/j.bjps.2026.04.034","type":"journal-article","created":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T15:11:30Z","timestamp":1777993890000},"page":"9-18","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":2,"special_numbering":"C","title":["Clinical safety and regenerative potential of a purified exosome product in treating skin graft donor sites: A phase 1b trial"],"prefix":"10.1016","volume":"118","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9029-4721","authenticated-orcid":false,"given":"Rou","family":"Wan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saranya P.","family":"Wyles","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunfeng","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atta","family":"Behfar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven L.","family":"Moran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"6","key":"10.1016\/j.bjps.2026.04.034_bib1","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1111\/j.1524-475X.2009.00543.x","article-title":"Human skin wounds: a major and snowballing threat to public health and the economy","volume":"17","author":"Sen","year":"2009","journal-title":"Wound Repair Regen"},{"issue":"2","key":"10.1016\/j.bjps.2026.04.034_bib2","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1089\/wound.2019.0946","article-title":"Human wounds and its burden: an updated compendium of estimates","volume":"8","author":"Sen","year":"2019","journal-title":"Adv Wound Care"},{"issue":"1","key":"10.1016\/j.bjps.2026.04.034_bib3","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/j.jval.2017.07.007","article-title":"An economic evaluation of the impact, cost, and Medicare policy implications of chronic nonhealing wounds","volume":"21","author":"Nussbaum","year":"2018","journal-title":"Value Health"},{"issue":"3","key":"10.1016\/j.bjps.2026.04.034_bib4","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1007\/s12325-017-0478-y","article-title":"Chronic wound healing: a review of current management and treatments","volume":"34","author":"Han","year":"2017","journal-title":"Adv Ther"},{"issue":"1","key":"10.1016\/j.bjps.2026.04.034_bib5","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1177\/1203475416664037","article-title":"Current status and future of skin substitutes for chronic wound healing","volume":"21","author":"Nicholas","year":"2017","journal-title":"J Cutan Med Surg"},{"issue":"8","key":"10.1016\/j.bjps.2026.04.034_bib6","article-title":"Evolving role of exosomes in plastic and reconstructive surgery and dermatology","volume":"12","author":"McGraw","year":"2024","journal-title":"Plast Reconstr Surg Glob Open"},{"issue":"13","key":"10.1016\/j.bjps.2026.04.034_bib7","doi-asserted-by":"crossref","first-page":"1033","DOI":"10.1093\/eurheartj\/ehz095","article-title":"Regeneration for all: an odyssey in biotherapy","volume":"40","author":"Behfar","year":"2019","journal-title":"Eur Heart J"},{"issue":"7","key":"10.1016\/j.bjps.2026.04.034_bib8","doi-asserted-by":"crossref","first-page":"3869","DOI":"10.3390\/ijms23073869","article-title":"The therapeutic potential of exosomes in soft tissue repair and regeneration","volume":"23","author":"Wan","year":"2022","journal-title":"Int J Mol Sci"},{"issue":"8","key":"10.1016\/j.bjps.2026.04.034_bib9","doi-asserted-by":"crossref","first-page":"1845","DOI":"10.1002\/jor.24587","article-title":"Characterization of a purified exosome product and its effects on canine flexor tenocyte biology","volume":"38","author":"Qi","year":"2020","journal-title":"J Orthop Res"},{"key":"10.1016\/j.bjps.2026.04.034_bib10","unstructured":"Rion2020:\u00a0Available at: \u3008https:\/\/www.rionhealth.com\/pep-technology\u3009."},{"issue":"9","key":"10.1016\/j.bjps.2026.04.034_bib11","doi-asserted-by":"crossref","first-page":"735","DOI":"10.36849\/JDD.8162","article-title":"Effect of topical human platelet extract (HPE) for facial skin rejuvenation: a histological study of collagen and elastin","volume":"23","author":"Wyles","year":"2024","journal-title":"J Drugs Dermatol"},{"issue":"1","key":"10.1016\/j.bjps.2026.04.034_bib12","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1038\/s41536-022-00240-9","article-title":"Exosome biopotentiated hydrogel restores damaged skeletal muscle in a porcine model of stress urinary incontinence","volume":"7","author":"Rolland","year":"2022","journal-title":"NPJ Regen Med"},{"key":"10.1016\/j.bjps.2026.04.034_bib13","article-title":"Optimized exosome isolation protocol for cell culture supernatant and human plasma","volume":"4","author":"Lobb","year":"2015","journal-title":"J Extra Vesicles"},{"issue":"13","key":"10.1016\/j.bjps.2026.04.034_bib14","doi-asserted-by":"crossref","first-page":"6616","DOI":"10.7150\/thno.57701","article-title":"TGF-\u03b2 loaded exosome enhances ischemic wound healing in vitro and in vivo","volume":"11","author":"Shi","year":"2021","journal-title":"Theranostics"},{"issue":"2","key":"10.1016\/j.bjps.2026.04.034_bib15","doi-asserted-by":"crossref","first-page":"200e","DOI":"10.1097\/PRS.0000000000008202","article-title":"Administration of purified exosome product in a rat sciatic serve reverse autograft model","volume":"148","author":"Ikumi","year":"2021","journal-title":"Plast Reconstr Surg"},{"issue":"10","key":"10.1016\/j.bjps.2026.04.034_bib16","doi-asserted-by":"crossref","first-page":"1185","DOI":"10.1093\/asj\/sjac149","article-title":"Efficacy and tolerability of topical platelet exosomes for skin rejuvenation: six-Week results","volume":"42","author":"Proffer","year":"2022","journal-title":"Aesthet Surg J"},{"issue":"1","key":"10.1016\/j.bjps.2026.04.034_bib17","doi-asserted-by":"crossref","first-page":"55","DOI":"10.2217\/rme-2022-0132","article-title":"Purified exosome product enhances chondrocyte survival and regeneration by modulating inflammation and promoting chondrogenesis","volume":"18","author":"Shi","year":"2023","journal-title":"Regen Med"},{"issue":"8","key":"10.1016\/j.bjps.2026.04.034_bib18","doi-asserted-by":"crossref","first-page":"1825","DOI":"10.1002\/jor.24859","article-title":"A novel engineered purified exosome product patch for tendon healing: an explant in an ex vivo model","volume":"39","author":"Shi","year":"2021","journal-title":"J Orthop Res"},{"issue":"12","key":"10.1016\/j.bjps.2026.04.034_bib19","article-title":"Intrinsic tendon regeneration after application of purified exosome product: an in vivo study","volume":"9","author":"Wellings","year":"2021","journal-title":"Orthop J Sports Med"},{"key":"10.1016\/j.bjps.2026.04.034_bib20","doi-asserted-by":"crossref","DOI":"10.1016\/j.biomaterials.2021.121019","article-title":"Effects of purified exosome product on rotator cuff tendon-bone healing in vitro and in vivo","volume":"276","author":"Ren","year":"2021","journal-title":"Biomaterials"},{"issue":"11","key":"10.1016\/j.bjps.2026.04.034_bib21","doi-asserted-by":"crossref","first-page":"3191","DOI":"10.1002\/bit.28520","article-title":"Dose-response analysis after administration of a human platelet-derived exosome product on neurite outgrowth in vitro","volume":"120","author":"Saffari","year":"2023","journal-title":"Biotechnol Bioeng"},{"issue":"6","key":"10.1016\/j.bjps.2026.04.034_bib22","doi-asserted-by":"crossref","first-page":"1247","DOI":"10.1097\/PRS.0000000000010389","article-title":"Enhancing functional recovery after segmental nerve defect using nerve allograft treated with plasma-derived exosome","volume":"152","author":"Wang","year":"2023","journal-title":"Plast Reconstr Surg"},{"issue":"3","key":"10.1016\/j.bjps.2026.04.034_bib23","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1097\/SPV.0000000000001017","article-title":"Impact of repeat dosing and mesh exposure chronicity on exosome-induced vaginal tissue regeneration in a porcine mesh exposure model","volume":"27","author":"Kisby","year":"2021","journal-title":"Female Pelvic Med Reconstr Surg"},{"issue":"10","key":"10.1016\/j.bjps.2026.04.034_bib24","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1097\/SPV.0000000000001005","article-title":"Exosome-Induced vaginal tissue regeneration in a porcine mesh exposure model","volume":"27","author":"Kisby","year":"2021","journal-title":"Female Pelvic Med Reconstr Surg"},{"issue":"17-18","key":"10.1016\/j.bjps.2026.04.034_bib25","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1089\/ten.tea.2023.0057","article-title":"A ready-to-use purified exosome product for volumetric muscle loss and functional recovery","volume":"29","author":"Mazzucchelli","year":"2023","journal-title":"Tissue Eng Part A"},{"issue":"6","key":"10.1016\/j.bjps.2026.04.034_bib26","doi-asserted-by":"crossref","first-page":"1006","DOI":"10.1016\/j.mayocp.2024.04.011","article-title":"Exosome therapy for a nonhealing scalp wound following chemoradiation and surgical therapy","volume":"99","author":"Pumford","year":"2024","journal-title":"Mayo Clin Proc"},{"issue":"5","key":"10.1016\/j.bjps.2026.04.034_bib27","doi-asserted-by":"crossref","DOI":"10.3390\/ijms25052642","article-title":"Pulmonary biodistribution of platelet-derived regenerative exosomes in a porcine model","volume":"25","author":"Rizzo","year":"2024","journal-title":"Int J Mol Sci"},{"key":"10.1016\/j.bjps.2026.04.034_bib28","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1016\/j.trsl.2024.02.001","article-title":"Nebulized platelet-derived extracellular vesicles attenuate chronic cigarette smoke-induced murine emphysema","volume":"269","author":"Xuan","year":"2024","journal-title":"Transl Res"},{"key":"10.1016\/j.bjps.2026.04.034_bib29","article-title":"Exosomes derived from human adipose mensenchymal stem cells accelerates cutaneous wound healing via optimizing the characteristics of fibroblasts","volume":"6","author":"Hu","year":"2016","journal-title":"Sci Rep"},{"issue":"1","key":"10.1016\/j.bjps.2026.04.034_bib30","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1186\/s12951-021-00942-0","article-title":"Hypoxia adipose stem cell-derived exosomes promote high-quality healing of diabetic wound involves activation of PI3K\/Akt pathways","volume":"19","author":"Wang","year":"2021","journal-title":"J Nanobiotechnology"},{"issue":"2","key":"10.1016\/j.bjps.2026.04.034_bib31","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1007\/s12015-020-09992-7","article-title":"Exosomes derived from human umbilical cord mesenchymal stem cells accelerate cutaneous wound healing by enhancing angiogenesis through delivering angiopoietin-2","volume":"17","author":"Liu","year":"2021","journal-title":"Stem Cell Rev Rep"},{"issue":"7","key":"10.1016\/j.bjps.2026.04.034_bib32","article-title":"First-in-human clinical trial of allogeneic, platelet-derived extracellular vesicles as a potential therapeutic for delayed wound healing","volume":"12","author":"Johnson","year":"2023","journal-title":"J Extra Vesicles"},{"issue":"1","key":"10.1016\/j.bjps.2026.04.034_bib33","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1186\/s13287-021-02262-4","article-title":"Chitosan hydrogel-loaded MSC-derived extracellular vesicles promote skin rejuvenation by ameliorating the senescence of dermal fibroblasts","volume":"12","author":"Zhao","year":"2021","journal-title":"Stem Cell Res Ther"},{"issue":"2","key":"10.1016\/j.bjps.2026.04.034_bib34","doi-asserted-by":"crossref","first-page":"1102","DOI":"10.1016\/j.bbrc.2017.09.056","article-title":"Exosomes derived from human umbilical cord blood mesenchymal stem cells stimulates rejuvenation of human skin","volume":"493","author":"Kim","year":"2017","journal-title":"Biochem Biophys Res Commun"},{"key":"10.1016\/j.bjps.2026.04.034_bib35","doi-asserted-by":"crossref","DOI":"10.1016\/j.biomaterials.2020.120264","article-title":"MSC-derived exosomes protect against oxidative stress-induced skin injury via adaptive regulation of the NRF2 defense system","volume":"257","author":"Wang","year":"2020","journal-title":"Biomaterials"},{"issue":"12","key":"10.1016\/j.bjps.2026.04.034_bib36","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1089\/wound.2019.1098","article-title":"The evolution of animal models in wound healing research: 1993-2017","volume":"8","author":"Parnell","year":"2019","journal-title":"Adv Wound Care"},{"issue":"7","key":"10.1016\/j.bjps.2026.04.034_bib37","doi-asserted-by":"crossref","first-page":"1525","DOI":"10.1016\/j.burns.2021.02.014","article-title":"Split-thickness skin graft donor-site morbidity: a systematic literature review","volume":"47","author":"Asuku","year":"2021","journal-title":"Burns"},{"issue":"12","key":"10.1016\/j.bjps.2026.04.034_bib38","doi-asserted-by":"crossref","first-page":"4389","DOI":"10.1111\/jocd.16561","article-title":"Topical Wharton's Jelly MSC-Derived Age Zero\u2122 exosome treatments after micro-needling for skin rejuvenation","volume":"23","author":"Cicchetti","year":"2024","journal-title":"J Cosmet Dermatol"},{"issue":"1","key":"10.1016\/j.bjps.2026.04.034_bib39","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1186\/s13287-018-0939-5","article-title":"Exosomes derived from human adipose tissue-derived mesenchymal stem cells alleviate atopic dermatitis","volume":"9","author":"Cho","year":"2018","journal-title":"Stem Cell Res Ther"}],"container-title":["Journal of Plastic, Reconstructive & Aesthetic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1748681526002494?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1748681526002494?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T07:35:30Z","timestamp":1782804930000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1748681526002494"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":39,"alternative-id":["S1748681526002494"],"URL":"https:\/\/doi.org\/10.1016\/j.bjps.2026.04.034","relation":{},"ISSN":["1748-6815"],"issn-type":[{"value":"1748-6815","type":"print"}],"subject":[],"published":{"date-parts":[[2026,7]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Clinical safety and regenerative potential of a purified exosome product in treating skin graft donor sites: A phase 1b trial","name":"articletitle","label":"Article Title"},{"value":"Journal of Plastic, Reconstructive & Aesthetic Surgery","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.bjps.2026.04.034","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}]}}