Transdermal application of azithromycin-amlodipine-heparin gel enhances survival of infected random ischaemic flap

Abstract

Transdermal application of a compound gel with AZM, AB, and LMWH combined is a promising method to prevent and treat flap infection, improve blood circulation, and increase the survival of infected ischaemic flaps.

The Review: The Discovery and Development of Amlodipine Drug

“…Topical formulation in the form of a gel containing dexamethasone (0.3%) and amlodipine (0.5%) for drug penetration in the flap tissue through the excised rat skin. It was observed that the compound gel containing both drugs could penetrate into the skin tissue which could significantly increase the viability of the ischemic skin flap 44 . Amlodipine has antioxidant properties and plays an important role in apoptosis 45 .…”

Edaravone promotes viability of random skin flaps via activating PI3K/Akt/mTOR signalling pathway‐mediated enhancement of autophagy

“…Random skin flap transplantations have been extensively applied in clinical medicine to treat and repair cutaneous defects, refractory wounds and large tumour resections, etc. 1,2 There is no axial vessels existing in random skin flaps and its blood supply is only from the pedicle bed, so that the length-to-width ratio of random skin flaps should not exceed 1.5-2.0, 3 which is a serious limitation for the clinical application of such types of skin flaps. Thus, there is a high likelihood that the distal parts of random skin flaps will suffer from necrosis to varying degrees if the length-to-width ratio of skin flaps exceed 1.5-2.0 because of under ischemic conditions.…”

Increased survivability of ischemic skin flap tissue in Flk‐1+/− mice by Pellino‐1 intervention

“…Several pharmacological compounds isolated from natural products and growth factors have been found to improve the survival of skin flap tissue. The transdermal application of heparin gel loaded with azithromycin‐amlodipine has been found to enhance the blood supply in the distal flap . The ability of the natural anticoagulant hirudin to promote angiogenesis over the ischemic skin flap was similarly studied by Pan et al …”