The use of a vasoactive drug on skin graft necrosis prevention in plastic surgery

ABSTRACT

The prevention of skin grafts ischemic changes in smokers submitted to plastic surgery, mainly inface and abdomen, with the vasoactive drug buflomedial was evaluated. It was an open randomized study, against a control group. The sample was 47 female patients, smoking more than 20 cigarettes a day, for at least 5 years. Both groups were comparable regarding patients characteristics, type of surgery, preoperative examinations --physical and laboratorial--and standardization of procedures. Buflomedil group received this medication I.V. in the immediate post-op period and oral throughout the 7th post-op day. In the buflomedil group only i out from 23 patients had skin graft ischemia and necrosis, against 5 out from 24 patients who had this problem in the control group. Statistical significance was not achieved (chi-square: p = 0.09), probably because insufficient sampel size. The necrosis area of the only case in buflomedil group was notably smaller than the necrosis area of any of the 5 cases in control group. There are strong evidences that buflomedil is an efficacious and ewll-tolerated drug for prevention of skin graft ischemia and necrosis in plastic surgery