Tadalafil significantly reduces ischemia reperfusion injury in skin island flaps

Abstract

Introduction: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.Materials and 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.

The effects of tadalafil and pentoxifylline on apoptosis and nitric oxide synthase in liver ischemia/reperfusion injury

“…PDE5 inhibitors have been shown to potentiate the vasodilator effect of NO, improving vascular function in patients with erectile dysfunction, pulmonary arterial hypertension, portal hypertension, and in cirrhotic rat liver [17,19–21]. Furthermore, it has been shown that the administration of TDF may also be useful against ischemic injury in other organs and tissues such as neurons, skin island flaps, ovary, myocardium, and kidney [10,22–25]. Baek et al.…”

Protective effect of tadalafil and verapamil on testicular function and oxidative stress after torsion/detorsion in adult male rat

“…Phosphodiesterase specifically inhibits the nitric oxide in the pathway of smooth muscle vessel. Tadalafil, by loosening the smooth muscles, increases the local perfusion and dilation of the vessels and inhibits platelet aggregation (Kayiran, Cuzdan, Uysal, & Kocer, ; Kulkarni & Patil, ), and also some study shows that the tadalafil has positive effect in the prevention of I/R injury(Kayiran et al., ; Kulkarni & Patil, ). Verapamil is a calcium channel blocker drug that derivates from phenylalkylamine and approved by FDA (Sertkaya et al., ).…”

Beneficial effects of Xuebijing injection on random skin flap survival in rats

“…The lengthewidth ratio cannot be >2:1, greatly limiting therapy applications of random skin flaps. Previous studies [3,4] have confirmed that ischemiaereperfusion (I/R) injury and neutrophil infiltration result in flap necrosis. Various kinds of agents have been tested to prevent skin flap ischemia, such as resveratrol [5], heparin [6], and vascular endothelial growth factor (VEGF) [7].…”