Kayiran Oguz, Cuzdan Suat S, Uysal Afsin, Kocer Ugur
Department of Plastic and Reconstructive Surgery Clinic, Izmir Ekol KBB Hospital, Ankara, Turkey.
Indian J Plast Surg. 2013 Jan;46(1):75-81. doi: 10.4103/0970-0358.113714.
Numerous pharmacological agents have been used to enhance the viability of flaps. Ischemia reperfusion (I/R) injury is an unwanted, sometimes devastating complication in reconstructive microsurgery. Tadalafil, a specific inhibitor of phosphodiesterase type 5 is mainly used for erectile dysfunction, and acts on vascular smooth muscles, platelets and leukocytes. Herein, the protective and therapeutical effect of tadalafil in I/R injury in rat skin flap model is evaluated.
Sixty epigastric island flaps were used to create I/R model in 60 Wistar rats (non-ischemic group, ischemic group, medication group). Biochemical markers including total nitrite, malondialdehyde (MDA) and myeloperoxidase (MPO) were analysed. Necrosis rates were calculated and histopathologic evaluation was carried out.
MDA, MPO and total nitrite values were found elevated in the ischemic group, however there was an evident drop in the medication group. Histological results revealed that early inflammatory findings (oedema, neutrophil infiltration, necrosis rate) were observed lower with tadalafil administration. Moreover, statistical significance (P < 0.05) was recorded.
We conclude that tadalafil has beneficial effects on epigastric island flaps against I/R injury.
众多药物制剂已被用于提高皮瓣的存活率。缺血再灌注（I/R）损伤是重建显微外科手术中一种不良的、有时甚至是毁灭性的并发症。他达拉非是一种特异性磷酸二酯酶5抑制剂，主要用于治疗勃起功能障碍，作用于血管平滑肌、血小板和白细胞。在此，评估他达拉非对大鼠皮瓣模型I/R损伤的保护和治疗作用。
使用60个上腹部岛状皮瓣在60只Wistar大鼠中建立I/R模型（非缺血组、缺血组、用药组）。分析包括总亚硝酸盐、丙二醛（MDA）和髓过氧化物酶（MPO）在内的生化标志物。计算坏死率并进行组织病理学评估。
缺血组MDA、MPO和总亚硝酸盐值升高，而用药组明显下降。组织学结果显示，使用他达拉非后早期炎症表现（水肿、中性粒细胞浸润、坏死率）较低。此外，具有统计学意义（P < 0.05）。
我们得出结论，他达拉非对上腹部岛状皮瓣抗I/R损伤具有有益作用。
