TITLE:
Effect of Topical Nitroglycerin on the Survival of Random Pattern Vascular Skin Flaps in a Rat Model: Pilot Study
AUTHORS:
Luis O. Flores-Salazar, Sergio E. Vázquez-Lara, Benjamín Jesús Moya-Leal, Gabriel A. Mecott-Rivera, Mauricio M. García-Pérez, Everardo Valdés-Flores, Yanko Castro-Govea
KEYWORDS:
Flap Survival, Nitroglycerin, Topical Nitroglycerin, Skin Flaps, Necrosis
JOURNAL NAME:
Open Access Library Journal,
Vol.10 No.8,
August
29,
2023
ABSTRACT: Background: The use of flaps is an important procedure in Plastic Surgery for the coverage of traumatic wounds, oncological resections, and burn reconstruction, among others. Drugs such as vasodilators (isoxsuprine, nitroglycerin), could increase tissue perfusion to optimize flap viability. In this study, the local and systemic effects of the use of topical nitroglycerin to increase the survival area of skin flaps were analyzed in a murine model. Methods: In our pilot study, we included twenty male Wistar rats, which underwent random pattern vascular flap formation surgery. Groups were designated as control (vaseline), 12-h local nitroglycerin, 24-h local nitroglycerin, and 12-h systemic nitroglycerin. The results were recorded with digitalized photographs of the flap to obtain the viability, necrotic, and total area measured after ten days of surgery. Results: The group of animals that received local nitroglycerin for 24-h had significantly higher survival and viability compared to the control group (P = 0.008). We did not observe differences in flap viability between the 12-h local nitroglycerin group and the control group, however, in the group with systemic nitroglycerin we observed a trend in reduction of viability. Conclusion: We demonstrate the increased viability of the random vascular pattern skin flap with the application of topical nitroglycerin. However, this beneficial effect was only observed in the schedule of local applications every 24 hours.