Statins: a new pharmacological agent for free flap surgery?
Microvascular free tissue transfer has become the standard for reconstruction in head and neck oncological surgery. Several pharmacological agents have been used in order to increase the success rate of this surgery, but there is currently no consensus for an ideal drug. We review the literature concerning the complications encountered in free flap surgery related to the ischaemia-reperfusion injury and detail the effects of statins relevant to this endothelial dysfunction. Statins, because of their pleiotropic effects such as preservation of vascular tone, anticoagulation and anti-inflammatory properties, appear to be useful in free flap surgery. This study highlights the benefits of statins in order to increase the success rate and the quality of the free flap. They should be included in the perioperative strategy, especially in patients with cardiovascular risk factors. A protocol is presented.
Department of Maxillofacial Surgery, University Paris 5, AP-HP, Pitié-Salpêtrière Hospital, Paris, France. gkarsenti@gmail.com
Guillaume
G
Karsenti
Yannick
Y
Le Manach
Stéphanie
S
Bouvier
André
A
Chaine
Chloé
C
Bertolus
D000818:Animals; D006258:Head and Neck Neoplasms / Q000601:surgery; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008833:Microcirculation; D008866:Microsurgery / Q000379:methods; D011183:Postoperative Complications / Q000517:prevention & control; D019651:Plastic Surgery Procedures / Q000009:adverse effects*; D015427:Reperfusion Injury / Q000517:prevention & control*; D013524:Surgical Flaps / Q000098:blood supply*; D016378:Tissue Transplantation / Q000009:adverse effects*
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors