Abstract

Flaps are important in covering defects caused by trauma, tumour excision, lower limb vascular ulcer, or diabetes mellitus. Distal flap necrosis is one of the most common postoperative complications for flaps, leading to increased morbidity, prolonged hospital stay and need for repeat surgery.Pentoxifylline (PTXF) is a vasoactive agent that improves the flow of blood by reducing its viscosity. In our patient, we studied the usefulness of pentoxifyllineas an adjuvant to prevent flap necrosis.

• 1.   Basu G, Downey H, Guo S, et al. Prevention of distal flap necrosis in a rat random skin flap model by gene electro transfer delivering VEGF(165) plasmid. J Gene Medicine. 2014; 16:55–65.
• 2.   Zeltzer AA, Van Landuyt K. Reconstruction of a massive lower limb softtissue defect by giant free DIEAP flap. J Plastic Reconstructive Aesthetic Surg. 2012;65(2):e42–5.
• 3.   Qing L, Wu P, Yu F, Zhou Z, Tang J. Use of dualskin paddle anterolateral thigh perforator flaps in the reconstruction of complex defect of the foot and ankle. J Plastic Reconstructive Aesthetic Surg. 2018;71(9):1231–8.
• 4.   Myers MB, Cherry G. Causes of necrosis in pedicle flaps. PlastReconstr Surg. 1968;42(1):43–50.
• 5.   Lin R, Lin J, Li S, et al. Effects of the traditional Chinese medicine baicalein on the viability of random pattern skin flaps in rats. Drug Des DevelTher. 2018;12: 2267–76.
• 6.   Van den Heuvel MG, Buurman WA, Bast A, van der Hulst RR. Review: ischaemia-reperfusion injury in flap surgery. J Plastic Reconstructive Aesthetic Surg. 2009;62(6):721–6.
• 7.   Sheng L, Yang M, Li H, Du Z, Yang Y, Li Q. Transplantation of adipose stromal cells promotes neovascularization of random skin flaps. Tohoku J Exp Med. 2011;224(3):229–34.
• 8.   Silva JJ, Pompeu DG, Ximenes NC, et al. Effects of Kaurenoic acid and arginine on random skin flap oxidative stress, inflammation, and cytokines in rats. AesthetPlast Surg. 2015;39(6):971.
• 9.   Deheng C, Kailiang Z, Weidong W, et al. Salidroside promotes random skin flap survival in rats by enhancing angiogenesis and inhibiting apoptosis. J ReconstrMicrosurg. 2016;32(8):580–6.
• 10.   Aral M, Tuncer S, Şencan A, Elmas Ç, Ayhan S. The effect of thrombolytic, anticoagulant, and vasodilator agents on the survival of random pattern skin flap. J ReconstrMicrosurg. 2015;31(7):487–92.
• 11.   6.Ward A, Clissold SP. Pentoxifylline. A review of its pharmacodynamic and pharmacokinetic properties, and its therapeutic efficacy. Drugs. 1987 Jul;34(1):50-97.
• 12.   7.Zhang M, Xu YJ, Mengi SA, Arneja AS, Dhalla NS. Therapeutic potentials of pentoxifylline for treatment of cardiovascular diseases. ExpClinCardiol. 2004 Summer;9(2):103-11.
• 13.   8.Kamphuis J, Smits P, Thien T. Vascular effects of pentoxifylline in humans. J CardiovascPharmacol. 1994 Oct;24(4):648-54.
• 14.   9.Ciuffetti G, Mercuri M, Ott C, Lombardini R, Paltriccia R, Lupattelli G, Santambrogio L, Mannarino E. Use of pentoxifylline as an inhibitor of free radical generation in peripheral vascular disease. Results of a double-blind placebo-controlled study. Eur J ClinPharmacol. 1991;41(6):511-5.
• 15.   P Pelissier, H Gardet, V Pinsolle, M Santoul, FC Behan. The keystone design perforator island flap. Part II: clinical applications. J PlastReconstrAesthet Surg. 2007;60(8):888–91.
• 16.   M Pignatti, M Pasqualini, M Governa, M Bruti, G Rigotti. Propeller flaps for leg reconstruction. J PlastReconstrAesthet Surg. 2008;61(1):777–83.
• 17.   FC Behan, CH Lo, A Sizeland, T Pham, M Findlay. Keystone Island Flap Reconstruction of Parotid Defects. PlastReconstr Surg. 2012;130(1):36e–41e.

Data Sharing Statement

Funding