Comment on “The effect of capsaicin ointment on skin for the survival of a cutaneous flap” by T. Miyawaki et al.

Comment on “The effect of capsaicin ointment on skin for the survival of a cutaneous flap” by... Eur J Plast Surg (2001) 24:31 DOI 10.1007/s002380000222 INVITED COMMENTAR Y M. Voigt Comment on “The effect of capsaicin ointment on skin for the survival of a cutaneous flap” by T. Miyawaki et al. Published online: 19 January 2001 © Springer-Verlag 2001 The authors present their interesting work about en- (group D). The authors explain this contradiction by sug- hancement of survival in failing skin flaps by a capsa- gesting that capsaicin ointment interfered with the icin-containing ointment. The study is straightforward wound healing process in the groups in which the oint- and well done. A rat model was chosen in which ment was applied topically. However, no wound infec- 2×10 cm abdominal skin flaps were raised which devel- tion or delayed wound healing was mentioned. oped necrosis at the distal randomized perfused edge. In A blood steal phenomenon and/or stasis of the flap’s this model the effect of capsaicin ointment on skin flap microcirculation due to vasodilation might account for survival was evaluated in four groups, applying the oint- the decreased survival in group D. In addition, the long ment base without capsaicin (group A), capsaicin onto term depletion of neuropeptides could play a role in con- the flap (group B), capsaicin onto the skin around the trolling the A-V shunts in and around the flap. Some flap (group C), and capsaicin ointment around the flap studies suggest these mechanisms [1,2]. Before capsaicin and on the flap's skin (group D). ointment can be used to enhance skin flap survival, one Interestingly, best flap survival was achieved in group should know where the substance should be placed to C, in which capsaicin ointment was applied on the nor- achieve the best effect. It might be interesting to design a mal abdominal skin sparing the flap itself. One would study comparing capsaicin and nitroglycerin effects on have expected the best survival to be seen in flaps which flap survival, because the mechanism of action of nitro- were surrounded and topically treated by the ointment glycerin is less complex than that of capsaicin. This commentary refers to the article: References s002380000221 M. Voigt ( ) 1. Chang CC, Maruyama Y, Inomata K (1990) Increased flap sur- Universität Freiburg, Chirurgische Klinik, vival after sensory denervation with capsaicin accompanied by Abteilung Plastische und Handchirurgie, delay. J Reconstr Microsurg 6:29–33 Hugstetter Strasse 55, 79106 Freiburg, Germany 2. Westin M, Heden P (1989) Sensory denervation with capsaicin e-mail: does not influence the critical ischemia time in rat island flaps. Tel.: +49-761-2702817, Fax: +49-761-2702501 Scand J Plast Reconstr Surg Hand Surg 23:173–176 European Journal of Plastic Surgery Springer Journals

Comment on “The effect of capsaicin ointment on skin for the survival of a cutaneous flap” by T. Miyawaki et al.

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Copyright © 2000 by Springer-Verlag
Medicine & Public Health; Plastic Surgery
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