Comparison of the effects of systemic sildenafil, tadalafil, and vardenafil treatments on skin flap survival in rats

Kaya, Burak; Çerkez, Cem; Işılgan, Servet Elçin; Göktürk, Hilal; Yığman, Zeynep; Serel, Savaş; Can, Belgin; Ergün, Hakan

doi:10.3109/2000656x.2015.1041024

Cited by 15 publications

(19 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the current study, sildenafil alone was able to decrease the extent of distal necrosis of the skin flaps. This finding was in harmony with the results of Kaya et al 43 , Sarifakioglu et al 44 , Tsai et al 45 and Shah et al 8 who used sildenafil also as a treatment and concluded that sildenafil is able to improve skin flap survival in a dose-dependent manner. In contrast, Figueiredo et al 46 , Barral et al 47 , Serin et al 4 and Ayyildiz et al 11 had revealed that sildenafil does not affect skin viability.…”

Section: Discussionsupporting

confidence: 88%

The Effects of Sildenafil and/or Nitroglycerin on Random-pattern Skin Flaps After Nicotine Application in Rats

Ellabban

Fattah

Kader

et al. 2020

Sci Rep

View full text Add to dashboard Cite

Smoking aggravates skin necrosis as a complication of random-pattern flap ischaemia. Sildenafil and nitroglycerin (NTG) are vasodilator agents that may affect skin flap survival. Fifty rats were subjected to a dorsal random-pattern flap operation and randomly divided into 5 groups. The control group received no treatment. The ischaemic group were administered local nicotine injections. The sildenafil group were administered oral sildenafil treatment in addition to the same intervention as the ischaemic group. The NTG group received topical NTG ointment application instead of sildenafil. The combined group were given both sildenafil and NTG treatments. After 7 days, all rats were sacrificed for flap assessment. Flap survival percentages at the 3 rd and 7 th days were significantly higher in the combined group than in the other study groups. Histologically, the ischaemic group exhibited dermal disorganization and inflammatory cell infiltration, which were improved in the 3 treated groups; however, the combined group presented the most relevant effect. The epidermal thickness showed a decrease in the ischaemic group (23.1 μm) that was significantly increased in the sildenafil (28.4 μm), NTG (28.8 μm) and combined (35.8 μm) groups. Immunohistochemically, the combined group exhibited a significant decrease in the apoptotic index and an increase in the proliferative index (2.3 and 56.9%, respectively) compared to those in the ischaemic (63.2 and 3%), sildenafil (41.7 and 28.1%) and NTG (39.3 and 30.4%) groups. Transmission electron microscopy (TEM) showed that the combined group displayed improvement in most of the ischaemic changes. Our analyses suggest that the combined use of sildenafil and NTG is more efficacious than using only one of these treatments for skin flap survival.Random skin flaps are widely used options for the reconstruction of large acquired or congenital skin defects 1 . Survival of these flaps is highly reliant on oxygen delivery to their tissues 2 . The main challenge is that the distal parts of the flap suffer from a reduced blood supply, which can trigger skin necrosis 3 . This reduction in the blood supply is mainly caused by anatomical or haemodynamic factors 4 . During vascular regeneration, ischaemia/reperfusion injury occurs, promoting oxidative stress and apoptosis 3 . Additionally, other factors, such as inadequate angiogenesis and inflammatory reactions, play roles in the pathogenesis of flap necrosis 5 .Skin flap ischaemic necrosis and increased incidence of infection can be aggravated by nicotine, which endangers the results of plastic skin reconstruction 6 . Smoking increases the risk of skin flap complications, which has been observed in clinical and experimental studies in both rats and hamsters 7 . Smokers have a higher risk of developing skin flap necrosis, namely, 13 times higher than that of non-smokers, which can result in flap loss or secondary contractures that negatively affect the aesthetic outcomes 6,8 . The potential mechanisms of this increased risk in smokers are highly...

show abstract

Section: Discussionsupporting

confidence: 88%

The Effects of Sildenafil and/or Nitroglycerin on Random-pattern Skin Flaps After Nicotine Application in Rats

Ellabban

Fattah

Kader

et al. 2020

Sci Rep

View full text Add to dashboard Cite

show abstract

“…In previous studies, other routes of sildenafil administration have resulted in confusing results on its effect on flap survival. Kaya et al 12 have shown that oral administration of sildenafil, tadalafil, and vardenafil have not led to a meaningful increase in the flap survival rate. Sarifakioglu et al 14 have also reported a similar result with oral sildenafil.…”

Section: ■ Discussionmentioning

confidence: 99%

“…Various studies have been made to investigate the effect of PDE5 inhibitors on flap survival [11][12][13][14][15][16] . These studies include oral and intraperitoneal administration of sildenafil.…”

Section: ■ Introductionmentioning

confidence: 99%

Preoperative subcutaneous sildenafil injection increases random flap survival in rats

Serin¹,

Altınel²,

Leblebıcı³

et al. 2018

Acta Cir. Bras.

View full text Add to dashboard Cite

show abstract

“…Sildenafil, both orally (1 mg/kg) and topically (0.5 mg/kg), significantly increased skin flap viability in rats [30]. Likewise, vardenafil and tadalafil could decrease necrotic area [31–33]. Similarly, sildenafil (1.4 mg/kg) saved the ovaries against both ischemia and torsion with a prominent decrease in oxidative stress and histological damaging score, as well as simultaneous increase in SOD (superoxide dismutase) [34].…”

Section: Protective Effect Of Sildenafil On Ischemic Organmentioning

confidence: 99%

Sildenafil beyond erectile dysfunction and pulmonary arterial hypertension: Thinking about new indications

Ala

Jafari

Dehpour

2020

Fundamemntal Clinical Pharma

View full text Add to dashboard Cite

Sildenafil, approved two decades ago, is the inhibitor of phosphodiesterase 5 (PDE5). First of all, it was designated for angina pectoris, but soon it showed a wonderful efficacy in erectile dysfunction (ED) and then pulmonary arterial hypertension (PAH). Due to the distribution of phosphodiesterase (PDE) in almost all organs, maybe it effects other diseases. Hence, a great number of investigations began to understand the role of PDEi in different organs. Preliminary research on sildenafil in cell culture and animal models has yielded promising results. Soon, a greater number of animal researches and clinical trials joined them. The results disclosed sildenafil can have beneficial effects in each organ such as heart, liver, kidney, brain, and intestines. Furthermore, it has significantly improved the prognosis of organ ischemia in various animal models. Clinical trials in several diseases, such as recurrent spontaneous miscarriage, fatty liver disease, bronchopulmonary dysplasia (BPD), heart failure, and premature ejaculation (PE) brought promising results. Although some clinical trials are available on the effects of sildenafil on various diseases, further studies on humans are needed to consolidate the ultimate effects of sildenafil. The aim of this review was to describe the effects of sildenafil on each organ and explain its mechanisms of action. Further, other PDE inhibitors such as tadalafil and vardenafil have been briefly discussed in parts of this review.

show abstract

Comparison of the effects of systemic sildenafil, tadalafil, and vardenafil treatments on skin flap survival in rats

Cited by 15 publications

References 25 publications

The Effects of Sildenafil and/or Nitroglycerin on Random-pattern Skin Flaps After Nicotine Application in Rats

The Effects of Sildenafil and/or Nitroglycerin on Random-pattern Skin Flaps After Nicotine Application in Rats

Preoperative subcutaneous sildenafil injection increases random flap survival in rats

Sildenafil beyond erectile dysfunction and pulmonary arterial hypertension: Thinking about new indications

Contact Info

Product

Resources

About