Tadalafil to improve cutaneous flap perfusion in smokers: A case series and literature review

Matin, Taraneh; Seyffert, Jennifer; Katz, Brian; Rivlin, Daniel

doi:10.1016/j.jdcr.2021.05.025

Cited by 4 publications

(5 citation statements)

References 6 publications

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“… 10 Even with the dosage of 5 mg/d of tadalafil for 3 postoperative days, with the first dose after the procedure, a protective effect of flap necrosis was observed in smokers. 14 …”

Section: Resultsmentioning

confidence: 99%

“…9 The common side effects of tadalafil include headaches, dyspepsia, myalgia, rhinitis, and flushing. 14 Cilostazol is a potent selective inhibitor of PDE type III that increases cAMP, decreasing intracellular calcium in muscle cells, causing cellular relaxation and vasodilation, in addition to promoting inhibition of platelet activation and aggregation, reducing thrombosis. 6 Optimization in the circulation of the flaps was observed with the use of cilostazol 30 mg/kg, orally, twice a day, 7 days before, and 7 days after surgery.…”

Section: Discussionmentioning

confidence: 99%

“… 9 The common side effects of tadalafil include headaches, dyspepsia, myalgia, rhinitis, and flushing. 14 …”

Section: Discussionmentioning

confidence: 99%

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Use of Phosphodiesterase Inhibitors in the Postoperative Period of Skin Flaps: A Systematic Review

Daronch

Marcante

Neto

et al. 2023

Plastic and Reconstructive Surgery - Global Open

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Background: Ischemia-reperfusion injury can occur in several clinical conditions, and it has been widely studied in the context of skin flaps. Vascular distress results in an imbalance between the supply and demand of oxygen to living tissues, and the result of this process is tissue necrosis. Several drugs have been studied to reduce vascular distress of skin flaps and tissue loss. Methods: The present study performed a systematic review of literature in the main databases (PubMed, Web of Science, LILACS, SciELO, and Cochrane), including articles published in the last 10 years. Results: It was observed that phosphodiesterase inhibitors, mainly types III and V, have shown promising results in terms of vascularization of the postoperative skin flap, especially when started on the first postoperative day and maintained for 7 days. Conclusion: New studies with different posology, duration of use, and new drugs are needed to better elucidate the use of this substance to optimize the circulation of skin flaps.

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“… 10 Even with the dosage of 5 mg/d of tadalafil for 3 postoperative days, with the first dose after the procedure, a protective effect of flap necrosis was observed in smokers. 14 …”

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Use of Phosphodiesterase Inhibitors in the Postoperative Period of Skin Flaps: A Systematic Review

Daronch

Marcante

Neto

et al. 2023

Plastic and Reconstructive Surgery - Global Open

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“…The following case series presents the successful off-label use of tadalafil in preventing tissue ischemia in high-risk patients and treating patients with early signs of tissue necrosis. 10 Tobacco cessation is often thought of as the domain of primary care physicians, but there is an ever-increasing amount of evidence that urologists are optimally positioned to screen patients for tobacco use and provide both counseling and cessation treatment. Studies have found smokers counseled on smoking cessation by their urologist increased their likelihood of success more than 4 times over those that were not counseled, and patients cite counseling from their urologist as the leading motivator in cessation attempts.…”

Section: Discussionmentioning

confidence: 99%

Smoking and Flap Survival: A Comprehensive Systematic Review

Nur Afiati,

Marini

2024

JARMHS

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Background: Free flap reconstruction of complex and/or large wounds, whether traumatic, following cancer resection, or for other reconstructive needs has become a commonly accepted practice. Multiple different types of free flaps are utilized for varying needs based on the individual patient and the defect that requires coverage. active smokers who underwent a nonelective traumatic reconstruction with a perforator-based fasciocutaneous flap (anterolateral thigh [ALT] flap) will have a higher incidence of smoking-related complications compared to the use of a muscle-only flap. The aim: The aim of this study to show about smoking and flap survival. Methods: By the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) 2020, this study was able to show that it met all of the requirements. This search approach, publications that came out between 2014 and 2024 were taken into account. Several different online reference sources, like Pubmed, SagePub, and Google Scholar were used to do this. It was decided not to take into account review pieces, works that had already been published, or works that were only half done. Result: In the PubMed database, the results of our search get 9 articles, whereas the results of our search on SagePub get 441 articles, on Google Scholar 4830 articles. Records remove before screening are 2771, so we get 2509 articles fos screening. After we screened based on record exclude, we compiled a total of 10 papers. We included five research that met the criteria. Conclusion: Smoking decreases the alveolar oxygen pressure and subcutaneous wound tissue oxygen, and nicotine causes vasoconstriction, smokers are more likely to experience flap loss, hematoma, or fat necrosis than non-smokers. Preoperative and post-operative abstinence period of at least 1 week is necessary for smokers who undergo flap operations.

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“…It was applied on the last 23 cases and was well tolerated, especially by male patients, according to the rest of the treatment components. 20…”

Section: Cilostazolementioning

confidence: 99%

The Treatment Algorithm in Diabetic Foot: An Alternative Against Amputation?

Güçer

2022

EMJ

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This clinical treatment modality was applied to 62 diabetic ulcers on lower extremities for which surgeons had been advised amputation. Total healing was achieved in 53 of them and was achieved through this treatment in a 3-month period. The remaining nine cases also showed improvement in healing at different levels, but they were not accepted as a ‘satisfactory result’. This treatment modality contains a synthetic prostacyclin analogue, two different phosphodiesterase inhibitors, a peripheral revascularisation agent, another agent increasing peripheral resistance to ischaemia, and a polysaccharide with positive rheologic properties on capillary circulation. Therefore, this treatment was found to be effective on circulation of the extremities, with radiologically-proven insufficient blood supply. The treatment also had a positive effect on recirculation and effects on collateral revascularisation through mechanical vacuum application, modified from standard vacuum treatments. With this combination, this technique was found extremely effective by application, according to the algorithm explained below, and should be an alternative to the current therapy applications in diabetic ulcers.

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Tadalafil to improve cutaneous flap perfusion in smokers: A case series and literature review

Cited by 4 publications

References 6 publications

Use of Phosphodiesterase Inhibitors in the Postoperative Period of Skin Flaps: A Systematic Review

Use of Phosphodiesterase Inhibitors in the Postoperative Period of Skin Flaps: A Systematic Review

Smoking and Flap Survival: A Comprehensive Systematic Review

The Treatment Algorithm in Diabetic Foot: An Alternative Against Amputation?

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