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.
KEY WORDS
Free radicals - ischemia - island flap - reperfusion injury - tadalafil