Effects of dimethylsulfoxide and pentoxifylline in the vitality of cutaneous flaps in rats.

Stephanie Luzia Da Costa Pedretti,Ana Paula Do Nascimento Duque,Maria Christina Marques Nogueira Castãnon,Tarcizo Afonso Nunes,Fernando Henrique Pereira,Cícero De Lima Rena

doi:10.1590/0100-69912017005006

Stephanie Luzia Da Costa Pedretti, Ana Paula Do Nascimento Duque + Show 4 more

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https://doi.org/10.1590/0100-69912017005006

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Abstract

to verify the influence of dimethylsulfoxide and pentoxifylline on the vitality of cutaneous flaps in rats and the tissue repair process. were studied 30 Wistar rats, submitting them to a 2cm wide by 8cm long dorsal cutaneous flap, of caudal base. We distributed the animals in three groups: Control Group (n=10) with application gauze moistened with 0.9% Saline in the flap bed for 30 seconds; Dimethylsulfoxide group (n=10), with administration of 1ml of 5% dimethylsulfoxide divided into five injections of 0.2ml in the transition of the flap segments; Pentoxifylline group (n=10), with administration of pentoxifylline 20mg/kg, diluted to 1ml and divided into five injections of 0.2ml in the transition of the flap segments. Drugs were administered intraoperatively, in a single dose and subcutaneously. We observed the skin flaps for changes in color and texture. On the 10th postoperative day, we checked the dimensions of viable and necrotic tissues, followed by excision of the specimen for histological analysis. the measurements of length of the viable and necrotic tissues between groups showed no differences. Histological analysis showed that the Dimethylsulfoxide group presented neovascularization, inflammatory infiltrate with leukocytes and more structured conjunctival stroma. The Pentoxifylline group showed neovascularization and inflammatory infiltrate, with moderate to intense granulation. The control group evolved with a higher rate of necrosis in the distal segment. dimethylsulfoxide and pentoxifylline influenced the vitality of the flap and the tissue repair process. However, they did not prevent necrosis macroscopically.

Highlights

Cutaneous flaps are one of the pillars of reconstructions in the specialty of Plastic Surgery
The present study aims to evaluate the effects of dimethylsulfoxide (DMSO) and pentoxifylline (PTFL) on the vitality of skin flaps in rats
We divided the sample into three groups, distributed as follows: Control group (n=10): gauze moistened with 0.9% saline solution in the flap bed for 30 seconds; DMSO group (n=10): injection of 1ml of 5% dimethylsulfoxide divided into five injections of 0.2ml in the transition of the flap segments; PTFL group (n=10): injection of pentoxifylline 20mg/kg, diluted with bidistilled water to complete the volume of 1ml and divided into five injections of 0.2ml in the transition of the flap segments

Summary

Introduction

Cutaneous flaps are one of the pillars of reconstructions in the specialty of Plastic Surgery. The cutaneous flap consists of elevation, detachment and repositioning in the bed, a procedure that can induce a series of events, among which vascular deficit, with reduced perfusion, for a variable and transient period[1]. Venous occlusion or congestion can be damaging to the vitality of the flap. Lymphatic vessels are injured, resulting in interstitial edema, contributing to the reduction of capillary perfusion. The sensory and sympathetic nerves are injured with the flap elevation, which causes the release of catecholamines, inducing vasoconstriction and reduction of the local blood supply. It is important to note that the skin flap has to survive the events that occur during the period of reduced perfusion[1]

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