Which monoclonal antibody is known to impair wound healing and should not be used within 28 days before or after surgery?

Bevacizumab, a monoclonal antibody that targets vascular endothelial growth factor (VEGF), is associated with impaired wound healing due to its mechanism of action in inhibiting blood vessel formation. This property is particularly relevant during the perioperative period, as adequate blood supply is crucial for proper wound healing after surgery. The recommendation to avoid using bevacizumab within 28 days before or after surgical procedures is based on clinical evidence that demonstrates an increased risk of complications such as delayed wound healing, dehiscence, and other post-operative issues when this drug is present in the body.

In contrast, the other monoclonal antibodies listed do not have the same well-documented risk for interfering with wound healing. For example, rituximab targets CD20 on B cells, trastuzumab targets the HER2 receptor, and nivolumab is a PD-1 inhibitor important in immune regulation. While these agents have their own sets of side effects and considerations, the evidence linking them specifically to impaired wound healing is not as pronounced as it is for bevacizumab. Therefore, healthcare professionals are particularly cautious with the use of bevacizumab around the time of surgery to ensure optimal patient outcomes.