An experimental study of the effect of pre-operative administration of cilostazol on random skin flap survival in rats: double blinded randomized controlled trial.
BACKGROUND
Insufficient arterial blood flow is the one cause of flap necrosis. Cilostazol is an inhibitor of phosphodiesterase III and increases cyclic AMP level in vascular smooth muscle cell causing vasodilation. Therefore, effect of cilostazol is expected to improve the viability of the flap.


METHODS
Double blinded randomized controlled trial was conducted. The study was to compare the survival of dorsal rat flaps between preoperative cilostazol supplemented diet and regular diet. The flap survival area was measured using PixArea Image software on post operative day 1,3,5 and 7. Fluorescein injection was performed to evaluate the exactly area of flap survival on postoperative day 7 and morphology of arterioles and venules were examined by histopathologic examination.


RESULTS
A statistical significance was found in the percentage of area of flap survival between cilostazol supplemented diet and control group on postoperative day 3, 5 and 7 (p < 0.05). Fluorescein injection showed the higher area of flap survival in cilostazol group than the control group (p < 0.05). Histopathologic examination showed dilation of vessels in the cilostazol group.


CONCLUSIONS
Preoperative cilostazol in rats can enhance skin flap survival.
Division of Plastic and Reconstructive Surgery, Department of Surgery, Phramongkutklao Hospital and Phramongkutklao College of Medicine, 315 Ratchawithi Road, Thung Phayathai, Ratchathewi, Bangkok, 10400 Thailand.
Chairat
C
Burusapat
Division of Plastic and Reconstructive Surgery, Department of Surgery, Phramongkutklao Hospital and Phramongkutklao College of Medicine, 315 Ratchawithi Road, Thung Phayathai, Ratchathewi, Bangkok, 10400 Thailand.
Janjira
J
Paengnoi
Army Institute of Pathology, Bangkok, Thailand.
Kantang
K
Satayasoontorn
Cilostazol; Flap survival; Random skin flap in rats