Is transdermal nitroglycerin application effective in preventing and healing flap ischaemia after modified radical mastectomy?

Author(s): Kutun S, Ay AA, Ulucanlar H, Tarcan O, Ay A, Aldan M, Gorkem G, Demir A, Cetin A

Affiliation(s): Department of General Surgery, Ankara Oncology Research and Training Hospital, Turkey.

Publication date & source: 2010-11, S Afr J Surg., 48(4):119-21.

Publication type: Randomized Controlled Trial

OBJECTIVE: We evaluated the efficacy of local nitroglycerin application in preventing and treating flap complications after modified radical mastectomy in a large patient cohort. PATIENTS AND METHODS: Between 1993 and 2008, 6426 patients undergoing surgery for stage II breast cancer were enrolled in this prospective study. Patients were randomised into treatment and control groups. In the treatment group a nitroglycerin preparation (Nitroderm) was applied to the flap area. Major complications, recovery periods, menopausal status, additional diseases (diabetes mellitus, hypertension, atherosclerotic heart disease) and adverse effects related to nitroglycerin use were recorded. RESULTS: The recovery rate without major complications was statistically significantly higher in the nitroglycerin-treated group than in the controls (p < 0.001). CONCLUSION: Our results indicate that topical nitroglycerin reduces flap complications after breast surgery.