Abstract
To investigate the effect of subcutaneous sildenafil on random flap survival. Fourteen Wistar rats, which were divided in to two groups, were used for this experimental study. Rats in the sildenafil group received subcutaneous sildenafil injections daily for seven days before flap elevation. At the end of the treatment period, 9x3 cm dorsal skin flaps were elevated and reinserted back into their place in all of the animals. Necrotic and whole flaps areas were recorded on graph papers. Seven days after the flap elevation samples for histological examination were taken and angiographies were performed to visualize the flap vascularization. The calculated average percentage of necrotic flap areas were 18.29% and 42.26% in the sildenafil and control group respectively.(p=0.0233). In selected angiography images, vessels were found to be more prominent in the sildenafil group. The average number of capillary formations under light microscopy was higher in the sildenafil group (p= 0.0286). The subdermal high dose sildenafil has a positive effect on flap survival.
Highlights
Random flaps are valuable tools in reconstructive surgery practice
Various side effects are associated with the systemic use of Phosphodiesterase type 5 (PDE5) inhibitors including low acute myocardial infarction[7,8,9], headache, flushing, nasal congestion, hearing loss and optic neuropathy[10]
Considering the systemic side effects of sildenafil, in this study we examined the efficiency of subcutaneous sildenafil injection prior to surgery on random flap survival
Summary
Random flaps are valuable tools in reconstructive surgery practice. Distal flap necrosis is commonly encountered in random flap surgery which can be caused by various anatomical or hemodynamic factors[1]. Various techniques and pharmacological agents have been studied to increase random flap survival[2,3,4]. Many of these studies have been adapted to wound healing and tissue perfusion applications. Sildenafil is a drug which inhibits Phosphodiesterase type 5 (PDE5) enzyme This inhibition leads to an increase in the intracellular cGMP level which causes dilatation of blood vessels and relaxation of smooth muscles. Various studies have been made to investigate the effect of PDE5 inhibitors on flap survival[11-16]. These studies include oral and intraperitoneal administration of sildenafil. Considering the systemic side effects of sildenafil, in this study we examined the efficiency of subcutaneous sildenafil injection prior to surgery on random flap survival
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