The effects of tadalafil on axial-pattern skin flap survival in rats.
BACKGROUND
Pharmacologic augmentation to mimic the delay phenomenon that increases skin flap survival has been studied extensively. Tadalafil is a phosphodiesterase V inhibitor that is used for treatment of erectile dysfunction by enhancing vascular smooth muscle relaxation.


OBJECTIVE
The aim of this study was to investigate the effects of local injection of tadalafil in enhancing axial-pattern skin flap survival in rats.


METHODS
Twenty Sprague-Dawley rats were used and a McFarlane-type caudally based axial-pattern skin flap was designed on the dorsum of the rat (2 x 9 cm). Rats were divided into two groups: the treatment group and the control group. Tadalafil 10 mg/kg/day was injected to the distal flap area of the treatment group for 3 days, and normal saline was injected for the control group. On Postoperative Day 7, necrotic flap area was measured and compared, and angiograms of the skin flaps were obtained in the two groups.


RESULTS
In the treatment group, the mean necrotic area was 21.9+/-6.4%, and in the control group, 37.7+/-5.9%. There was a statistically significant increase of skin flap survival in the treatment group (p=.001). Angiography also showed vasodilation of the choke vessels between adjacent angiosomes to form true anastomosis in the treatment group.


CONCLUSIONS
The results demonstrate that the use of local injection of tadalafil to failing skin flaps increases the survival of axial-pattern flaps in rats.
Oh
Myungjune
M
Department of Plastic & Reconstructive Surgery, Research Institute of Plastic & Reconstructive Surgery (RIPRS), College of Medicine, Seoul National University, Seoul, Korea.
Chang
Hak
H
Minn
Kyung Won
KW
D000818:Animals; D002243:Carbolines / Q000008:administration & dosage / Q000494:pharmacology*; D006085:Graft Survival / Q000187:drug effects*; D007279:Injections, Subcutaneous; D008297:Male; D009336:Necrosis; D010726:Phosphodiesterase Inhibitors / Q000008:administration & dosage / Q000494:pharmacology*; D051381:Rats; D017207:Rats, Sprague-Dawley; D013524:Surgical Flaps / Q000098:blood supply / Q000473:pathology*; D000068581:Tadalafil
D002243:Carbolines; D010726:Phosphodiesterase Inhibitors; D000068581:Tadalafil