Williams P B, Hankins D B, Layton C T, Phan T, Pratt M F
Department of Pharmacology, Eastern Virginia Medical School, Norfolk.
Arch Otolaryngol Head Neck Surg. 1994 Jan;120(1):65-71. doi: 10.1001/archotol.1994.01880250057008.
Optimizing survival of random skin flaps is essential to ensure successful rehabilitation of patients in whom flap reconstruction is necessary. This study tested the hypothesis that pentoxifylline improves random skin flap survival in porcine dorsal flank flaps when administered for at least 2 weeks preoperatively. Specific aims included establishing the mechanisms by which pentoxifylline enhanced survival. Treatment with pentoxifylline (25 mg/kg per day) for 14 days before surgery and for 7 days thereafter significantly increased mean flap survival to 73.2% +/- 4.5% compared with mean flap survival of 49.6% +/- 2.2% in untreated pigs. Increased flap survival was associated with a parallel increase in red blood cell flexibility. Plasma concentration of pentoxifylline ranged from 92.9 to 122.7 ng/mL but did not correlate directly with the improved flap survival. Likewise, pentoxifylline decreased platelet aggregation; there was a trend toward increased flap survival in those pigs with the least amount of aggregation. Thus, pentoxifylline improves random flap survival but only after a sufficient pretreatment period of at least 14 days.
优化随意皮瓣的存活情况对于确保需要皮瓣重建的患者成功康复至关重要。本研究检验了以下假设：术前至少给药2周时，己酮可可碱可提高猪背部侧腹皮瓣的随意皮瓣存活率。具体目标包括确定己酮可可碱提高存活率的机制。术前14天及术后7天每天用己酮可可碱（25毫克/千克）治疗，与未治疗猪的皮瓣平均存活率49.6%±2.2%相比，显著提高至73.2%±4.5%。皮瓣存活率增加与红细胞柔韧性的平行增加相关。己酮可可碱的血浆浓度范围为92.9至122.7纳克/毫升，但与皮瓣存活率的改善无直接相关性。同样，己酮可可碱降低了血小板聚集；在聚集量最少的猪中，皮瓣存活率有增加的趋势。因此，己酮可可碱可提高随意皮瓣存活率，但至少需要14天的充分预处理期。
