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Long-term pretreatment with pentoxifylline increases random skin flap survival
P B Williams1, D B Hankins, C T Layton
1Department of Pharmacology, Eastern Virginia Medical School, Norfolk.
Archives of Otolaryngology--Head & Neck Surgery
|January 1, 1994
Summary
Pentoxifylline significantly improves random skin flap survival in pigs when given for at least two weeks before surgery. This drug enhances red blood cell flexibility and reduces platelet aggregation, aiding flap survival.
Area of Science:
- Plastic Surgery
- Pharmacology
- Regenerative Medicine
Background:
- Optimizing random skin flap survival is critical for successful patient rehabilitation after flap reconstruction.
- Understanding pharmacological interventions that enhance flap viability is an ongoing area of research.
Purpose of the Study:
- To test the hypothesis that pentoxifylline improves random skin flap survival in a porcine model.
- To establish the mechanisms by which pentoxifylline may enhance flap survival.
Main Methods:
- Porcine dorsal flank flaps were used to evaluate random skin flap survival.
- Pentoxifylline was administered at 25 mg/kg/day for 14 days preoperatively and 7 days postoperatively.
- Red blood cell flexibility and platelet aggregation were measured to assess drug mechanisms.
Main Results:
- Pentoxifylline significantly increased mean flap survival from 49.6% to 73.2%.
- Improved flap survival correlated with increased red blood cell flexibility.
- Pentoxifylline decreased platelet aggregation, with a trend towards better survival in pigs with less aggregation.
Conclusions:
- A minimum of 14 days of preoperative pentoxifylline administration is necessary to significantly improve random skin flap survival.
- Pentoxifylline enhances flap survival through mechanisms including improved red blood cell flexibility and reduced platelet aggregation.