Terazosin blockade of nicotine-induced skin flap necrosis in the rat.
OBJECTIVE
To examine the ability of terazosin hydrochloride to block the decrease in skin flap survival induced by nicotine.


METHODS
A randomized controlled animal trial.


METHODS
Ninety-two male Sprague-Dawley rats were randomized to 1 of 5 groups: double-placebo control (n = 15), nicotine opposed by oral placebo (n = 26), nicotine opposed by subcutaneous placebo (n = 16), nicotine opposed by oral terazosin (n = 21), and nicotine opposed by subcutaneous terazosin (n = 14).


METHODS
All rats received 1 mg of nicotine twice daily via subcutaneous injection except for those in the double-placebo control group, which received saline injections twice daily, for the 6-week study. The terazosin treatment groups received 1.5 mg of terazosin hydrochloride twice daily either orally or subcutaneously while the rest received a saline solution placebo either orally or subcutaneously for the last 4 weeks of the study. At the end of the fifth week, a 4 x 10-cm, caudally based, dorsal random-pattern flap was elevated and repositioned. The outcome was measured in percentage area of flap survival.


RESULTS
The mean (+/-SEM) area of flap survival for the double-placebo control group was 79% +/- 2%. Nicotine opposed by oral placebo or subcutaneous placebo produced a significant decrease in survival areas (mean [+/-SEM] area, 73% +/- 2% and 74% +/- 2%, respectively). Nicotine opposed by oral terazosin produced a mean (+/-SEM) survival area of 81% +/- 2%, which was significantly better than the nicotine opposed by placebo group and similar to the control group (P = .02).


CONCLUSIONS
Use of oral terazosin elevated flap survival rates to control levels in nicotine-treated rats.
Karien
R G
RG
Department of Otolaryngology, University of Minnesota, Minneapolis, USA.
Maisel
R H
RH
D000317:Adrenergic alpha-Antagonists / Q000494:pharmacology* / Q000627:therapeutic use; D000818:Animals; D006085:Graft Survival / Q000187:drug effects*; D008297:Male; D009336:Necrosis; D009538:Nicotine / Q000009:adverse effects*; D011224:Prazosin / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D011897:Random Allocation; D051381:Rats; D017207:Rats, Sprague-Dawley; D013524:Surgical Flaps / Q000473:pathology*
D000317:Adrenergic alpha-Antagonists; D009538:Nicotine; C041226:Terazosin; D011224:Prazosin