title: Comparison of the effects of systemic sildenafil, tadalafil, and vardenafil treatments on skin flap survival in rats.
abstract: OBJECTIVE
  The most important issue in flap surgery is flap viability. This study aimed to compare the effects of most commonly used phosphodiesterase type 5 (PDE5) inhibitors on flap survival.
  
  
  METHODS
  A 3 × 9 cm flap was elevated from the dorsum of 32 Wistar albino rats. In the control group, saline was administered 2 hours before the flap elevation and continued for 2 days after the surgery. In the sildenafil, tadalafil, and vardenafil groups, the related drug was administered. Blood flow in the flaps was monitored with laser Doppler flowmetry. On postoperative day 7, flaps were photographed and biopsies were obtained.
  
  
  RESULTS
  The ratios of flap necrosis area in the tadalafil, sildenafil, and vardenafil groups were lower than that in the control group, but without significant difference (p = 0.077). Histopathological evaluation revealed no significant difference among the groups.
  
  
  CONCLUSIONS
  The ratio of flap necrosis area tended to be lower in the groups receiving oral PDE5 inhibitors than in the control group, although not statistically significant. The role of PDE5 inhibitors needs to be evaluated in larger studies before a conclusion can be made regarding their effects on flap viability.
authors.affiliation: a 1 Department of Plastic, Reconstructive and Aesthetic Surgery, Ankara University School of Medicine , Ankara, Turkey.
authors.forename: Burak
authors.initials: B
authors.lastname: Kaya
authors.affiliation: a 1 Department of Plastic, Reconstructive and Aesthetic Surgery, Ankara University School of Medicine , Ankara, Turkey.
authors.forename: Cem
authors.initials: C
authors.lastname: Çerkez
authors.affiliation: a 1 Department of Plastic, Reconstructive and Aesthetic Surgery, Ankara University School of Medicine , Ankara, Turkey.
authors.forename: Servet Elçin
authors.initials: SE
authors.lastname: Işılgan
authors.affiliation: b 2 Department of Histology and Embryology, Yıldırım Beyazıt University School of Medicine , Ankara, Turkey.
authors.forename: Hilal
authors.initials: H
authors.lastname: Göktürk
authors.affiliation: c 3 Department of Histology and Embryology.
authors.forename: Zeynep
authors.initials: Z
authors.lastname: Yığman
authors.affiliation: a 1 Department of Plastic, Reconstructive and Aesthetic Surgery, Ankara University School of Medicine , Ankara, Turkey.
authors.forename: Savaş
authors.initials: S
authors.lastname: Serel
authors.affiliation: c 3 Department of Histology and Embryology.
authors.forename: Belgin
authors.initials: B
authors.lastname: Can
authors.affiliation: d 4 Department of Medical Pharmacology, Ankara University School of Medicine , Ankara, Turkey.
authors.forename: Hakan
authors.initials: H
authors.lastname: Ergün
mesh_terms: D000818:Animals; D001707:Biopsy, Needle; D001783:Blood Flow Velocity / Q000187:drug effects; D004195:Disease Models, Animal; D005260:Female; D006084:Graft Rejection / Q000517:prevention & control*; D007150:Immunohistochemistry; D007262:Infusions, Intravenous; D017078:Laser-Doppler Flowmetry; D008833:Microcirculation / Q000187:drug effects / Q000502:physiology; D011897:Random Allocation; D051381:Rats; D017208:Rats, Wistar; D012016:Reference Values; D000068677:Sildenafil Citrate / Q000494:pharmacology*; D016038:Skin Transplantation / Q000009:adverse effects / Q000379:methods*; D013524:Surgical Flaps / Q000098:blood supply / Q000637:transplantation; D000068581:Tadalafil / Q000494:pharmacology*; D000069058:Vardenafil Dihydrochloride / Q000494:pharmacology*; D014945:Wound Healing / Q000502:physiology
chemical_list: D000069058:Vardenafil Dihydrochloride; D000068581:Tadalafil; D000068677:Sildenafil Citrate
keywords: Flaps; necrosis; phosphodiesterase type 5 inhibitors; sildenafil; tadalafil; vardenafil