The Influence of Pentoxifylline on Skin-Flap Survival

Monteiro, Dennis T.; Santamore, William P.; Nemir, Paul

doi:10.1097/00006534-198602000-00019

Cited by 44 publications

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“…As the peak effects of pentoxifylline may take up to 2–4 weeks, a dosage of 400 mg three times a day should be initiated 2 weeks prior to surgery. 100 Skin flap survival in rats 101 and swine 102 was enhanced when given pentoxifylline at doses of 20 mg/kg/day for 10 days before and after surgery. Similar results were observed in rats with parenteral administration of pentoxifylline on the day of surgery.…”

Section: Vascular Drugsmentioning

confidence: 99%

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The effects of drugs on wound healing–‐part II. Specific classes of drugs and their effect on healing wounds

et al. 2000

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Classes of drugs in wound healingDrugs can inhibit or assist wound healing. The effect of a speci®c drug depends on its mechanism of action, dosage, route, and administration in relation to the speci®c phase of wound healing. A discussion of the major classes of drugs that impact wound healing follows, with Tables 1±8 summarizing the effects of major classes of drugs. Generic and trade names used in this paper are summarized in Table 9. Table 1 lists the effects of anti-in¯ammatory agents on wound healing. Anti-in¯ammatory agents CorticosteroidsCorticosteroids affect almost every phase of wound healing because of their inhibitory effect on gene expression in various cells. The in¯ammatory phase of wound healing is affected as corticosteroids inhibit prostaglandin synthesis. 1±4 The recruitment and phagocytic properties of neutrophils 5 and macrophages 6 are decreased causing delayed removal of bacteria and foreign bodies. 7 Lymphocyte recruitment and antibody formation by B lymphocytes is reduced. 2 The antimitotic activity 8 causes decreased epithelial regeneration 4 and granulation tissue formation 4,9 affecting the tissue formation phase. A thinned epidermis occurs due to a reduced rate of keratinocyte proliferation and an increased rate of differentiation. 9,10 Granulation tissue formation is reduced due to decreased ®broblast proliferation, 9 resulting in less collagen, 11 proteoglycans, and glycosaminoglycans. 12±14 A decreased oxygen and reduced nutrient supply 14 may result from steroid-induced vasoconstriction caused by the inhibition of the potent vasodilator prostaglandin E 2 (PGE 2 ) 15 and by the enhanced smooth muscle contraction of vessel walls. 14 As the number of macrophages in the tissue is decreased under the in¯uence of steroids, cytokine stimulation provided by macrophages for normal ®broplasia and angiogenesis is diminished. 6 The tissue remodeling phase is affected by decreased collagen and ground substance synthesis. Decreased numbers of ®broblasts are seen and wound contraction is reduced. 16 Steroid atrophy leads to a thinned dermis and the development of striae 17 (Fig. 1). Interestingly, corticosteroids also decrease collagen degradation by decreasing collagenase production. 18 The most pronounced effects are noted when steroids are administered during the early in¯ammatory phase. 19±21 The suppression of macrophage-orchestrated events by steroids in early in¯ammation is thought to play a role. 22 While oral doses of prednisone (above 10 mg per day) adversely affect wound healing during the ®rst 3 days, high-dose prednisone (at or above 40 mg per day) is needed to effect ®broplasia and collagen remodeling during subsequent days. 21 Inhibition of wound contracture in open wounds occurs regardless of the timing of corticosteroid administration. 20 Steroids affect cells by altering gene expression after they cross cell membranes, bind to cytoplasmic receptors, and translocate into the nucleus. 23,24 The degree of inhibition of gene expression is related to the potency of the steroid. 2...

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Section: Vascular Drugsmentioning

confidence: 99%

“…95 Ketanserin, a serotonergic blocker, is helpful in treating ischemic ulcers, livedoid vasculitis, and stasis ulcers. 98–105 It should be noted that all anesthetics, except for cocaine, have some vasodilatory effect. The long‐term use of vasodilators for treating leg ulcer wounds is not recommended.…”

Section: Vascular Drugsmentioning

confidence: 99%

The effects of drugs on wound healing–‐part II. Specific classes of drugs and their effect on healing wounds

et al. 2000

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“…In this study, an increase in the flap viability was shown, but other details were not mentioned [7]. In this study, an increase in the flap viability was shown, but other details were not mentioned [7].…”

Section: Discussionmentioning

confidence: 56%

The effect of parenteral pentoxifylline therapy on skin flap survival

et al. 1993

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“…Our study also showed that there were significant differences between the diabetic and nondiabetic rats with regard to the tensile strength of the scar tissue. On the other hand, although a few experimental studies [2,11,16,28] and one clinical study [27] concluded that pentoxifylline increases flap tissue survival, it was shown that pentoxifylline reduces collagen synthesis and increases the collagenases activity in fibroblasts both in vivo and in vitro [4,22]. Regarding these previous studies, it was predicted that the wound tensile strength of the pentoxifylline-treated rats would be significantly reduced.…”

Section: Discussionmentioning

confidence: 99%

“…The effects of pentoxifylline on flap survival in rats was studied and it was found to improve flap survival by 50% [16]. It was concluded that pentoxifylline can reduce the microvascular and macrovascular complications of diabetes mellitus [7].…”

Section: Discussionmentioning

confidence: 99%

The effect of pentoxifylline on the healing of full-thickness skin defects of diabetic and normal rats

Karasoy¹,

Kuran

Turan

et al. 2002

European Journal of Plastic Surgery

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In this paper, the effects of systemic pentoxifylline administration on normal and diabetic wound healing are studied. Twenty-four normoglycemic and 24 diabetic rats were compared, exploring the healing of standardized (15×15 mm) full-thickness wounds by secondary intention. Twelve rats of both groups received intraperitoneal pentoxifylline 10 mg/kg per day. The strength of the healed tissues was evaluated by straining tests, the healing time of each wound was recorded, and the healed tissues were examined histologically. In the diabetic group, the only significant difference between the rats receiving pentoxifylline and the others was the shortened healing time. Pentoxifylline significantly reduced the time needed for complete epithelization and also increased the tensile strength significantly in normoglycemic rats. As expected, significant differences were recorded between the normoglycemic and diabetic rats regarding healing time and scar tissue strength. In conclusion, systemic pentoxifylline administration may be helpful in shortening the healing time of full-thickness wounds both in diabetic and normoglycemic patients, and it can increase the tensile strength of the healed wound in normoglycemic organisms. Materials and methodsForty-eight adult male Sprague-Dawley rats (weighing 200-300 g) were obtained from the breeding colony of the Microsurgery Research Laboratory of Istanbul Şişli Etfal Teaching Hospital. The rats were divided into four equal groups of 12: normoglycemic A. Karasoy ( ✉ ) Şemsettin Günaltay Cad. Gürsoylu Sok., Intaş Sitesi Z Blok No: 25/12,

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The Influence of Pentoxifylline on Skin-Flap Survival

Cited by 44 publications

References 0 publications

The effects of drugs on wound healing–‐part II. Specific classes of drugs and their effect on healing wounds

The effects of drugs on wound healing–‐part II. Specific classes of drugs and their effect on healing wounds

The effect of parenteral pentoxifylline therapy on skin flap survival

The effect of pentoxifylline on the healing of full-thickness skin defects of diabetic and normal rats

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