Effect of sildenafil citrate on viability of flaps: An experimental study in rats

Abstract

Various pharmacological agents have been used to try and elucidate the pathophysiology of ischaemia and necrosis of flaps. Their most important disadvantage is the need for relatively high doses given systemically, which increases the risk of potential side effects. Topical or local agents are more useful. Sildenafil citrate, the specific inhibitor of cyclic guanosine monophosphate (cGMP)-specific phosphodiesterase type 5 (PDE 5) was studied as an antianginal drug during the late 1980s, but is now used for its effect on erectile function in men. Sildenafil citrate causes dilatation of peripheral arteries and veins and the inhibition of the thrombus-forming ability of platelets in vivo. Our study was designed to test the efficacy of sildenafil citrate on the viability of flaps.

Thrombospondins: from structure to therapeutics

“…Numerous therapeutic agents have been and continue to be developed for the purpose of selectively increasing tissue blood flow to under-perfused tissue units. In several animal models of tissue ischemia, therapy employing L-arginine, cGMP phosphodiesterase inhibitors, or NO donors has increased tissue survival [111][112][113][114][115][116][117][118]. Since we have identified TSP1 as a major physiological regulator of NOsignaling in vascular cells, we investigated whether TSP1 could likewise regulate tissue blood flow.…”

Effects of sildenafil on the viability of random skin flaps

“…Conversely, Ayyildiz et al 7 reported the daily use of sildenafil subdermally, even though the type of restraint was not described.…”

“…On the distal third, however, there was a tendency to develop less granulation tissue in flaps treated with sildenafil ( Table 2). Ayyildiz et al 7 , which also applied it subdermally and was not increased due to the systemic response leading to the death of three animals in the study group.…”

“…Some auxiliary therapeutic resources were proposed in the attempt to improve flap survival, such as autonomization 1 , intramuscular use of ketorolac 2 , corticosteroids and carnitine 3 , hyperbaric oxygen therapy 4 , pentoxifylline 5 , buflomedil 6 , and even sildenafil isolated or in association with endothelial vascular growth or fibrin glue [7][8][9][10][11] . However, response to these systemic treatments may be associated with adverse effects, for example hypotension, amnesia, visual disturbances, migraine and even vascular accidents 12 .…”

Comparison of Ferulic Acid and Sildenafil, Therapeutic Role against Testicular Injury Induced by Cadmium Chloride in Adult Male Albino Rat

“…This antioxidant compound prevent lipid oxidation in food and prevent free-radicalinduced diseases such as aging caused by oxidative tissue degeneration, atherosclerosis and cancer, [6]. Sildenafil citrate, considered a specific inhibitor of cyclic guanosine monophosphate (cGMP)-specific phosphodiesterase type-5 (PDE-5), causes dilation of the peripheral veins and arteries due to enhanced nitric oxide (NO) synthesis [7], so used for treatment of erectile dysfunction. Several studies investigated the lipid peroxidation inhibition by cGMP analogues and cyclic adenosine Green Master Mix (QIAGEN Science, Maryland, USA), and nuclease-free water to a total volume of 20 μl.…”