Ketorolac (Toradol) and Acute Random-Pattern Skin Flap Survival in Rat

Davis, Richard E.; Cohen, James I.; Robinson, J.; Urben, Susan L.; Cook, Ted A.

doi:10.1001/archotol.1995.01890060071014

Cited by 10 publications

(10 citation statements)

References 18 publications

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“…15 Although ketorolac has been studied in an animal model of random-flap ischemia, showing no beneficial effect, its use in microcirculation models of 1-R injury remains unknown. 16 Our first objective was to look at the effect of ketorolac on neutrophil adhesion. We found that ketorolac significantly decreased adherent and rolling leukocytes in reperfused venules following 4 hr of muscle ischemia.…”

Section: Discussionmentioning

confidence: 99%

Effect of Ketorolac Tromethamine (Toradol) on Ischemia‐Reperfusion Injury in Skeletal Muscle

Yao¹,

Roth²,

Stephenson³

et al. 1998

J reconstr Microsurg

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The eicosanoids, leukotriene B4 (LTB4) and thromboxane A2 (TXA2), contribute to neutrophil adhesion and arteriole vasoconstriction, important microcirculatory events in ischemia-reperfusion (I-R) injury. The purpose of this study was to evaluate the effect of ketorolac on I-R injury of skeletal muscle. A videomicroscopic preparation of gracilis muscle in male Wistar rats (n=7) in two experimental groups was evaluated: Group 1-4 hr global ischemia only (19 arterioles, 19 venules), and Group 2-4 hr ischemia plus ketorolac (13 arterioles, 14 venules). Ketorolac (0.86 mg/kg, i.m.) was given 30 min prior to reperfusion. The number of neutrophils, rolling and adherent, was counted in 100-micron venular segments, and arteriole diameters were measured at 5, 15, 30, 60 and 120 min of reperfusion. The I-R-induced increase in neutrophil adhesion was significantly reduced by ketorolac, which significantly increased arteriolar vasodilation in the first 30 min of reperfusion and significantly reduced the I-R-induced vasoconstriction in arterioles at 30 min; this effect was lost at 1 hr of reperfusion. Although ketorolac augments immediate arteriole vasodilation and blocks subsequent vasoconstriction, this effect appears to be transient. These findings suggest that ketorolac may have potential as a treatment for I-R injury.

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Section: Discussionmentioning

confidence: 99%

Effect of Ketorolac Tromethamine (Toradol) on Ischemia‐Reperfusion Injury in Skeletal Muscle

Yao¹,

Roth²,

Stephenson³

et al. 1998

J reconstr Microsurg

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“…Some auxiliary therapeutic resources were proposed in the attempt to improve flap survival, such as autonomization 1 , intramuscular use of ketorolac 2 , corticosteroids and carnitine 3 , hyperbaric oxygen therapy 4 , pentoxifylline 5 , buflomedil 6 , and even sildenafil isolated or in association with endothelial vascular growth or fibrin glue [7][8][9][10][11] . However, response to these systemic treatments may be associated with adverse effects, for example hypotension, amnesia, visual disturbances, migraine and even vascular accidents 12 .…”

Section: Introductionmentioning

confidence: 99%

Effects of sildenafil on the viability of random skin flaps

et al. 2011

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Purpose:To assess the viability of McFarlane skin flaps in rats with administration of sildenafil. Methods: Twenty Wistar rats were distributed into two groups: Control (dorsal skin flap, subdermal application of saline solution at 0.9%) and Study (dorsal skin flap, subdermal application of sildenafil). Seven days after the surgery, flaps were photographed and graphically rendered. Then, they were analyzed with AutoCAD software. Three biopsies (proximal, medial and distal) of each flap were collected for histological analysis. Results: Macroscopic analysis showed that animals of the study group had greater necrotic areas (p=0.003) in the dorsal skin flaps. Additionally, histological analysis of the distal third of these flaps showed a tendency to less granulated tissue formation in animals treated with sildenafil. Conclusion: Sildenafil subdermally was associated with lower viability of the random skin flap in rats. Key words: Wound Healing. Surgical Flaps. Cyclic GMP. Nitric Oxide. Rats. RESUMOObjetivo: Avaliar a viabilidade de retalhos cutâneos de ratos à McFarlane após a administração de sildenafil. Métodos: Vinte ratos Wistar foram distribuídos em dois grupos: Controle (confecção do retalho cutâneo dorsal, aplicação subdérmica de solução salina a 0,9%) e Estudo (confecção do retalho cutâneo dorsal, aplicação subdérmica de sildenafil). Sete dias após a operação, os retalhos foram fotografados e representados graficamente, para serem analisados com o programa AutoCad. Três biópsias (cranial, média e caudal) foram coletadas de cada retalho, para análise histológica. Resultados: A análise macroscópica evidenciou que os animais do grupo Estudo apresentaram maiores áreas de necrose (p=0,003) nos retalhos cutâneos dorsais. Além disso, a análise histológica dos terços distais dos retalhos mostrou uma tendência à formação de menos tecido de granulação nos animais que receberam o sildenafil. Conclusão: O sildenafil subdérmico esteve associado com uma pior viabilidade tecidual dos retalhos cutâneos dorsais de ratos. Descritores: Cicatrização de Feridas. Retalhos Cirúrgicos. GMP Cíclico. Óxido Nítrico. Ratos.

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“…Other therapies used to maximize flap survivability have produced mixed results but include the use of hyperbaric oxygen, leeches, and staged surgical delay 5–10 . A number of pharmacologic experimental treatment modalities have been explored to decrease flap necrosis, including the use of vascular endothelium growth factor (VEGF), ketorolac, topical lidocaine and prilocaine (EMLA), dexamethasone and carnitine, topical oleic acid, and nitric oxide (NO) 11–16 . Other agents such as sympatholytics, hemorheologic agents, free radical scavengers, and vasodilators have also been tested.…”

Section: Introductionmentioning

confidence: 99%

“…[5][6][7][8][9][10] A number of pharmacologic experimental treatment modalities have been explored to decrease flap necrosis, including the use of vascular endothelium growth factor (VEGF), ketorolac, topical lidocaine and prilocaine (EMLA), dexamethasone and carnitine, topical oleic acid, and nitric oxide (NO). [11][12][13][14][15][16] Other agents such as sympatholytics, hemorheologic agents, free radical scavengers, and vasodilators have also been tested. To date, however, there is no clinically approved, reliable, or widely accepted pharmacologic treatment for the failing flap.…”

Section: Introductionmentioning

confidence: 99%