title: Tadalafil significantly reduces ischemia reperfusion injury in skin island flaps.
abstract: BACKGROUND
  Numerous pharmacological agents have been used to enhance the viability of flaps. Ischemia reperfusion (I/R) injury is an unwanted, sometimes devastating complication in reconstructive microsurgery. Tadalafil, a specific inhibitor of phosphodiesterase type 5 is mainly used for erectile dysfunction, and acts on vascular smooth muscles, platelets and leukocytes. Herein, the protective and therapeutical effect of tadalafil in I/R injury in rat skin flap model is evaluated.
  
  
  METHODS
  Sixty epigastric island flaps were used to create I/R model in 60 Wistar rats (non-ischemic group, ischemic group, medication group). Biochemical markers including total nitrite, malondialdehyde (MDA) and myeloperoxidase (MPO) were analysed. Necrosis rates were calculated and histopathologic evaluation was carried out.
  
  
  RESULTS
  MDA, MPO and total nitrite values were found elevated in the ischemic group, however there was an evident drop in the medication group. Histological results revealed that early inflammatory findings (oedema, neutrophil infiltration, necrosis rate) were observed lower with tadalafil administration. Moreover, statistical significance (P < 0.05) was recorded.
  
  
  CONCLUSIONS
  We conclude that tadalafil has beneficial effects on epigastric island flaps against I/R injury.
authors: Department of Plastic and Reconstructive Surgery Clinic, Izmir Ekol KBB Hospital, Ankara, Turkey.
authors: Oguz
authors: O
authors: Kayiran
authors: Suat S
authors: SS
authors: Cuzdan
authors: Afsin
authors: A
authors: Uysal
authors: Ugur
authors: U
authors: Kocer
keywords: Free radicals; ischemia; island flap; reperfusion injury; tadalafil
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