The Effect of Capsaicin on the Viability and Angiogenesis of Random-Pattern Skin Flaps

Abstract

Objective: Random flaps are often the first choice of technique in plastic surgery, however, necrosis developing in the distal portion of the flap during angiogenesis may necessitate additional surgery. Prolonged treatment is expensive in terms of labor, time, and morale. Several drugs have been investigated as a means of improving the viability of random flaps, and while satisfactory results have been reported, potential side effects due to systemic use and high costs have prevented widespread clinical use. This study examined capsaicin as a resource for improved viability and angiogenesis in random flaps. Methods: Random-pattern, dorsal, McFarlane skin flaps were created in 60 male Wistar albino rats weighing 180–230 g (experimental group: n=30; control group: n=30) and sutured back into place. Capsaicin 0.1% cream was applied on the flap postoperatively and topically twice daily for 7 days in the experimental group. The necrosis rate was calculated using Sasaki's paper template method. Results: The ratio of the necrotic portion of the flap to the total flap was 22.9+-8.94% in the experimental group and 36.8+-10.05% in the control group. Analysis of polymorphonuclear leukocyte infiltration, lymphocyte ratio, capillary proliferation, and other parameters indicated that the application of capsaicin cream had a positive effect on flap viability in some zones in the experimental group. Conclusion: Significantly less necrosis was seen in the experimental group. The results suggest that capsaicin 0.1% cream may increase the viability of random pattern skin flaps. However, differences in transdermal application characteristics between species, between individuals, and even between regions in a single individual demonstrate the need for additional studies.

Keywords

• angiogenesis of flap
• capsaicin; random-pattern skin flaps; viability of flap.