Korean J Otorhinolaryngol-Head Neck Surg.  2023 Dec;66(12):865-871. 10.3342/kjorl-hns.2023.00997.

Effects of Intramuscular Epinephrine Injection and Systemic Sildenafil Citrate on Rat Transverse Rectus Abdominis Musculocutaneous Flap Survival

• Lee DH
• Yeo J
• Park S
• Cho SH
• Kim S
• Kim JS
• Kim BG
• Chang KH
• Park JO

• KMID: 2549469
• DOI: http://doi.org/10.3342/kjorl-hns.2023.00997

Abstract

Background and Objectives
Flaps are commonly employed for reconstruction, and many studies have sought to improve flap survival. In this study, we determined whether sildenafil and epinephrine synergistically improve the survival rate of transverse rectus abdominis musculocutaneous (TRAM) flaps. Materials and Method Twenty-four Sprague-Dawley rats were divided into four groups of six rats each: a control group, an epinephrine group, a sildenafil group, and an epinephrineplus- sildenafil group. TRAM flaps were elevated on the upper abdomen.
Results
The average flap survival area and number of blood vessels differed significantly between the control and experimental groups; however, the various experimental groups did not differ significantly. The level of vascular epithelial growth factor was higher in the experimental groups than in the control group.
Conclusion
Both epinephrine and sildenafil citrate significantly improve TRAM flap survival in rats. However, whether effects are better when the drugs are combined rather than when used alone remains unclear. Further research is required.

Keyword

Epinephrine; Ischemic preconditioning; Sildenafil citrate; Surgical flaps