Eur J Plast Surg (2001) 24:32 DOI 10.1007/s002380000223 AUTHOR’S REPLY Takeshi Miyawaki Published online: 19 January 2001 © Springer-Verlag 2001 I thank Professor M. Voigt for the commentary he pro- so that blood flow to the flap is decreased. However, vided on our paper. He mentioned that it might be inter- capsaicin, a neurobinding peptide, binds to peripheral esting to compare the effects on flap survival of both ni- nerves and causes a temporary block on their activity troglycerin and capsaicin. Nitroglycerin, known as a po- without having any systemic effect. Thus the effect of tent venodilator as well as arteriodilator, has been used capsaicin is significantly localized and this is its great in patients with ischemic heart disease. It was delivered advantage. transcutaneously or intravenously. Several investigators have used it in their experimental models to prove the ef- fect of nitroglycerin on flap survival, and some have References shown increased flap survival when nitroglycerin was 1. Rohrich RJ, Cherry GW, Spina M (1984) Enhancement of skin- used [1,2, 3]. However, recent studies have shown that flap survival using nitroglycerin ointment. Plast Reconstr Surg nitroglycerin ointment has no beneficial effect on ran- 76:943–948 dom pattern flap survival in rats  or in clinical use in 2. Waters LM, Pearl RM, Macaulay RM (1989) A comparative humans . Nitroglycerin applied to the skin will be ab- analysis of the ability of five classes of pharmacological agents to augment skin flap survival in various models and species: an sorbed through the lymphatic or venous system, dilating attempt to standardize skin flap research. Ann Plast Surg 23: these vessels and moving into the systemic circulation. 117–122 Once nitroglycerin is administered, it will affect all the 3. Price MA, Pearl RM (1994) Multiagent pharmacotherapy to en- vessels systemically and may reduce the blood pressure hance skin flap survival: Lack of additive effect of nitroglycer- in and allopurinol. Ann Plast Surg 33:52–56 This reply refers to the invited commentary at http://dx.doi.org/ 4. Smith DK, Dolan RW (1999) Effects of vasoactive topical 10.1007/s002380000222 agents on the survival of dorsal skin flaps in rats. Otolaryngol Head Neck Surg 121:220–223 5. Dunn CL, Brodland DG, Griego RD, Huether MJ, Fazio MJ, T. Miyawaki ( ) Institute for Craniofacial and Reconstructive Surgery, Zitelli JA (2000) A single postoperative application of nitro- 16001 West Nine Mile Road, Third Floor, Fisher Center, glycerin ointment does not increase survival of cutaneous flaps Southfield, MI 48075, USA and grafts. Dermatol Surg 26:425–427
European Journal of Plastic Surgery – Springer Journals
Published: Jan 1, 2001
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