title: Is transdermal nitroglycerin application effective in preventing and healing flap ischaemia after modified radical mastectomy?
abstract: OBJECTIVE
  We evaluated the efficacy of local nitroglycerin application in preventing and treating flap complications after modified radical mastectomy in a large patient cohort.
  
  
  METHODS
  Between 1993 and 2008, 6426 patients undergoing surgery for stage II breast cancer were enrolled in this prospective study. Patients were randomised into treatment and control groups. In the treatment group a nitroglycerin preparation (Nitroderm) was applied to the flap area. Major complications, recovery periods, menopausal status, additional diseases (diabetes mellitus, hypertension, atherosclerotic heart disease) and adverse effects related to nitroglycerin use were recorded.
  
  
  RESULTS
  The recovery rate without major complications was statistically significantly higher in the nitroglycerin-treated group than in the controls (p < 0.001).
  
  
  CONCLUSIONS
  Our results indicate that topical nitroglycerin reduces flap complications after breast surgery.
authors.affiliation: Department of General Surgery, Ankara Oncology Research and Training Hospital, Turkey.
authors.forename: Suat
authors.initials: S
authors.lastname: Kutun
authors.forename: Aybala Agac
authors.initials: AA
authors.lastname: Ay
authors.forename: Haluk
authors.initials: H
authors.lastname: Ulucanlar
authors.forename: Oguz
authors.initials: O
authors.lastname: Tarcan
authors.forename: Ahmet
authors.initials: A
authors.lastname: Ay
authors.forename: Mete
authors.initials: M
authors.lastname: Aldan
authors.forename: Guven
authors.initials: G
authors.lastname: Gorkem
authors.forename: Abdullah
authors.initials: A
authors.lastname: Demir
authors.forename: Abdullah
authors.initials: A
authors.lastname: Cetin
mesh_terms: D000287:Administration, Topical; D000328:Adult; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D007511:Ischemia / Q000188:drug therapy*; D016015:Logistic Models; D015411:Mastectomy, Modified Radical; D008875:Middle Aged; D009336:Necrosis; D009367:Neoplasm Staging; D005996:Nitroglycerin / Q000008:administration & dosage*; D011183:Postoperative Complications / Q000188:drug therapy*; D011446:Prospective Studies; D013524:Surgical Flaps; D016896:Treatment Outcome; D014945:Wound Healing / Q000187:drug effects*
chemical_list: D005996:Nitroglycerin