Prevention of Wound Edge Necrosis by Local Application of Dimethylsulfoxide

Çelen, Orhan; Yıldırım, Ertan; Berberoğlu, Uğur

doi:10.1080/00015458.2005.11679718

Cited by 10 publications

(13 citation statements)

References 18 publications

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“…32 Its local anesthetic effects may also reduce oxidative stress by tempering cellular excitation. 30 It is possible that a number of these effects work in concert to yield the results seen in the studies mentioned above and our experience presented here. Indeed, even a single dose of DMSO, either intra- or immediately postoperatively seems to be effective in our experience, perhaps alleviating vasospasm and oxidative stress during this critical time period.…”

Section: Discussionsupporting

confidence: 51%

“…It is known to cause histamine release by mast cells and also increase prostaglandin E1 production, both ways in which it may induce vasodilation. 23,30,31 DMSO is also a hydroxyl-inactivating compound, giving it the ability to reduce ischemia-reperfusion injury by scavenging free radical species. 32 Its local anesthetic effects may also reduce oxidative stress by tempering cellular excitation.…”

Section: Discussionmentioning

confidence: 99%

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Topical Dimethyl Sulfoxide for Congested Nipple–areolar Complexes in Breast Surgery: A Pilot Study

Silverstein

McLean

Crowley

et al. 2022

Plastic and Reconstructive Surgery - Global Open

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Background: Necrosis of the nipple-areolar complex (NAC) is a major complication of breast surgery that most commonly results from venous congestion. Several conservative rescue therapies have been proposed for relieving NAC congestion, but each carries certain drawbacks, including cost and side effect profile. In this study, we evaluated the effectiveness of topical dimethyl sulfoxide (DMSO), an inexpensive compound with vasodilatory, free radical scavenging, and antiinflammatory properties in rescuing congested NACs. Methods: We conducted a review of all 15 patients treated with DMSO for NAC congestion at our institution between May 2019 and October 2020. DMSO was applied in liquid form on a soaked gauze pad in the hospital; patients were instructed to apply a DMSO cream to the NAC twice a day following discharge. Patient characteristics and data related to DMSO treatment and NAC healing were compared via univariate analysis. Results: Eighteen congested NACs from 15 patients who underwent mastectomy, breast reduction, mastopexy, or breast reconstruction were treated with DMSO. Of the 18 treated NACs, 15 healed with DMSO treatment alone. The average length of DMSO treatment was 9.4 ± 8.5 days (mean ± standard deviation); NAC healing took place over 9.9 ± 9.6 days. There were no complications related to DMSO treatment. Conclusions: This pilot study shows that DMSO may be an effective topical treatment for NAC congestion following breast surgery. Given its low cost, ease of application, and lack of side effects, future studies should prospectively compare DMSO against other topical treatments, like nitroglycerin ointment.

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Section: Discussionsupporting

confidence: 51%

Section: Discussionmentioning

confidence: 99%

Topical Dimethyl Sulfoxide for Congested Nipple–areolar Complexes in Breast Surgery: A Pilot Study

Silverstein

McLean

Crowley

et al. 2022

Plastic and Reconstructive Surgery - Global Open

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“…Hongying and colleagues10 studied 216 women who underwent radical surgery for breast cancer and recommended less use of electrocautery, injection of adrenaline (epinephrine) into the subcutaneous tissue, routine use of drains, and the application of pressure dressings to reduce skin flap complications. Other clinical studies have indicated that local application of dimethylsulphoxide11 and transcutaneous electrical nerve stimulation12 may decrease skin flap necrosis after mastectomy. In addition, increased surgeon experience has been found to be associated with fewer postoperative complications after skin‐sparing mastectomy13.…”

Section: Discussionmentioning

confidence: 99%

Randomized clinical trial of Chinese herbal medications to reduce wound complications after mastectomy for breast carcinoma

Chen

et al. 2010

British Journal of Surgery

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“…Mastectomy, either modified radical or skin-sparing, was performed in a total of 8439 breasts from 7895 patients across studies included. Preventive non-surgical adjuncts against mastectomy flap necrosis included five different interventions: (1) Transcutaneous Electrical Nerve Stimulation, 16 (2) Topical Dimethylsulfoxide ointment (DMSO), 17 (3) Oral Cilostazol, 18 (4) Topical Nitroglycerin Ointment, [19][20][21][22][23] and (5) Closed-Incision Negative Pressure Wound Therapy (NWPT). [24][25][26] Studies reviewed included six prospective randomized trials, two prospective non-randomized trials, four retrospective cohort studies.…”

Section: Study Characteristicsmentioning

confidence: 99%

Non‐operative adjuncts for the prevention of mastectomy skin flap necrosis: a systematic review and meta‐analysis

Tang

Chow

et al. 2022

ANZ Journal of Surgery

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Background: Native skin flap necrosis is a potentially devastating complication following skin-sparing or nipple-sparing mastectomy with a reported incidence of as high as 30%. Treatment depends on the depth and extent of tissue necrosis and can range from dressings to surgical debridement and further reconstruction. This can have implications on patient physical and psychological wellbeing as well as cost of treatment. This study aims to identify and appraise cost-effective non-surgical adjuncts for the prevention of native skin flap necrosis. Methods: A systematic review was performed using the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement and structured around existing recommended guidelines. A search of MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature and ClinicalTrials.gov was performed with the medical subject headings 'mastectomy' and 'flap necrosis'. After exclusion, 12 articles were selected for review and analysed. Results: A total of 8439 mastectomies were performed on 7895 patients. Preventative nonsurgical adjuncts that demonstrated statistically significant reduction in mastectomy flap necrosis included topical nitroglycerin ointment (P = 0.000), closed-Incision negative pressure wound therapy (P = 0.000), topical dimethylsulfoxide ointment (P = 0.03), oral cilostazol (P = 0.032), and local heat pre-conditioning (P = 0.047). Conclusions: This study identifies multiple adjuncts that may aid in preventing mastectomy skin flap necrosis, especially in high-risk patients. Further studies could aim to define standardized protocols and compare the various adjuncts in different circumstances.

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Prevention of Wound Edge Necrosis by Local Application of Dimethylsulfoxide

Abstract: The application of DMSO reduced skin flap necrosis and improved outcome of surgical flaps.

Cited by 10 publications

References 18 publications

Topical Dimethyl Sulfoxide for Congested Nipple–areolar Complexes in Breast Surgery: A Pilot Study

Topical Dimethyl Sulfoxide for Congested Nipple–areolar Complexes in Breast Surgery: A Pilot Study

Randomized clinical trial of Chinese herbal medications to reduce wound complications after mastectomy for breast carcinoma

Non‐operative adjuncts for the prevention of mastectomy skin flap necrosis: a systematic review and meta‐analysis

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