The effect of low-dose nitroglycerin ointment on skin flap necrosis in breast reconstruction after skin-sparing or nipple-sparing mastectomy

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Abstract

Background Skin flap necrosis is a common complication after mastectomy and breast reconstruction. It has been proven that nitroglycerin ointment, as a topical vasodilator, can decrease the rate of skin flap necrosis after mastectomy and breast reconstruction. However, nitroglycerin can cause several side effects, including headache, dizziness, and hypotension. The purpose of this study was to evaluate whether the application of a low dose of nitroglycerin ointment reduced the rate of skin flap necrosis in breast reconstruction after skin-sparing or nipple-sparing mastectomy. Methods A total of 73 cases of breast reconstruction after nipple-sparing and skin-sparing mastectomy at our institution from March 2012 to January 2017 were retrospectively studied. Of these patients, 52 received nitroglycerin ointment (4.5 mg) application to the skin around the nipple-areolar complex from August 2015 to January 2017, while 21 received fusidic acid ointment from March 2012 to August 2015. The number of patients who experienced necrosis of the breast skin flap was counted in both groups. Results Skin flap necrosis developed in 2 (3.8%) patients who were treated with nitroglycerin ointment and 5 (23.8%) patients who did not receive nitroglycerin ointment treatment. Patients who did not receive nitroglycerin ointment treatment had a significantly higher risk of mastectomy skin flap necrosis than patients who did (odds ratio= 7.81; 95% confidence interval, 1.38 to 44.23; P= 0.02). Conclusions Low-dose nitroglycerin ointment administration significantly decreased the rate of skin flap necrosis in patients who underwent breast reconstruction after skin-sparing or nipple-sparing mastectomy, without increasing the incidence of the side effects of nitroglycerin.

Original languageEnglish
Pages (from-to)509-515
Number of pages7
JournalArchives of Plastic Surgery
Volume44
Issue number6
DOIs
Publication statusPublished - 2017 Nov 1

Fingerprint

Nipples
Mammaplasty
Mastectomy
Nitroglycerin
Ointments
Necrosis
Skin
Fusidic Acid
Dizziness
Vasodilator Agents
Hypotension
Headache
Breast
Odds Ratio
Confidence Intervals

Keywords

  • Flap
  • Necrosis
  • Nitroglycerin
  • Ointments
  • Skin

ASJC Scopus subject areas

  • Surgery

Cite this

@article{56d9fc6b55214e57bd4321568517893c,
title = "The effect of low-dose nitroglycerin ointment on skin flap necrosis in breast reconstruction after skin-sparing or nipple-sparing mastectomy",
abstract = "Background Skin flap necrosis is a common complication after mastectomy and breast reconstruction. It has been proven that nitroglycerin ointment, as a topical vasodilator, can decrease the rate of skin flap necrosis after mastectomy and breast reconstruction. However, nitroglycerin can cause several side effects, including headache, dizziness, and hypotension. The purpose of this study was to evaluate whether the application of a low dose of nitroglycerin ointment reduced the rate of skin flap necrosis in breast reconstruction after skin-sparing or nipple-sparing mastectomy. Methods A total of 73 cases of breast reconstruction after nipple-sparing and skin-sparing mastectomy at our institution from March 2012 to January 2017 were retrospectively studied. Of these patients, 52 received nitroglycerin ointment (4.5 mg) application to the skin around the nipple-areolar complex from August 2015 to January 2017, while 21 received fusidic acid ointment from March 2012 to August 2015. The number of patients who experienced necrosis of the breast skin flap was counted in both groups. Results Skin flap necrosis developed in 2 (3.8{\%}) patients who were treated with nitroglycerin ointment and 5 (23.8{\%}) patients who did not receive nitroglycerin ointment treatment. Patients who did not receive nitroglycerin ointment treatment had a significantly higher risk of mastectomy skin flap necrosis than patients who did (odds ratio= 7.81; 95{\%} confidence interval, 1.38 to 44.23; P= 0.02). Conclusions Low-dose nitroglycerin ointment administration significantly decreased the rate of skin flap necrosis in patients who underwent breast reconstruction after skin-sparing or nipple-sparing mastectomy, without increasing the incidence of the side effects of nitroglycerin.",
keywords = "Flap, Necrosis, Nitroglycerin, Ointments, Skin",
author = "Yun, {Min Ho} and Yoon, {Eul Sik} and Byung-Il Lee and Park, {Seung Ha}",
year = "2017",
month = "11",
day = "1",
doi = "10.5999/aps.2017.00934",
language = "English",
volume = "44",
pages = "509--515",
journal = "Archives of Plastic Surgery",
issn = "2234-6163",
publisher = "Korean Society of Plastic and Reconstructive Surgeons",
number = "6",

}

TY - JOUR

T1 - The effect of low-dose nitroglycerin ointment on skin flap necrosis in breast reconstruction after skin-sparing or nipple-sparing mastectomy

AU - Yun, Min Ho

AU - Yoon, Eul Sik

AU - Lee, Byung-Il

AU - Park, Seung Ha

PY - 2017/11/1

Y1 - 2017/11/1

N2 - Background Skin flap necrosis is a common complication after mastectomy and breast reconstruction. It has been proven that nitroglycerin ointment, as a topical vasodilator, can decrease the rate of skin flap necrosis after mastectomy and breast reconstruction. However, nitroglycerin can cause several side effects, including headache, dizziness, and hypotension. The purpose of this study was to evaluate whether the application of a low dose of nitroglycerin ointment reduced the rate of skin flap necrosis in breast reconstruction after skin-sparing or nipple-sparing mastectomy. Methods A total of 73 cases of breast reconstruction after nipple-sparing and skin-sparing mastectomy at our institution from March 2012 to January 2017 were retrospectively studied. Of these patients, 52 received nitroglycerin ointment (4.5 mg) application to the skin around the nipple-areolar complex from August 2015 to January 2017, while 21 received fusidic acid ointment from March 2012 to August 2015. The number of patients who experienced necrosis of the breast skin flap was counted in both groups. Results Skin flap necrosis developed in 2 (3.8%) patients who were treated with nitroglycerin ointment and 5 (23.8%) patients who did not receive nitroglycerin ointment treatment. Patients who did not receive nitroglycerin ointment treatment had a significantly higher risk of mastectomy skin flap necrosis than patients who did (odds ratio= 7.81; 95% confidence interval, 1.38 to 44.23; P= 0.02). Conclusions Low-dose nitroglycerin ointment administration significantly decreased the rate of skin flap necrosis in patients who underwent breast reconstruction after skin-sparing or nipple-sparing mastectomy, without increasing the incidence of the side effects of nitroglycerin.

AB - Background Skin flap necrosis is a common complication after mastectomy and breast reconstruction. It has been proven that nitroglycerin ointment, as a topical vasodilator, can decrease the rate of skin flap necrosis after mastectomy and breast reconstruction. However, nitroglycerin can cause several side effects, including headache, dizziness, and hypotension. The purpose of this study was to evaluate whether the application of a low dose of nitroglycerin ointment reduced the rate of skin flap necrosis in breast reconstruction after skin-sparing or nipple-sparing mastectomy. Methods A total of 73 cases of breast reconstruction after nipple-sparing and skin-sparing mastectomy at our institution from March 2012 to January 2017 were retrospectively studied. Of these patients, 52 received nitroglycerin ointment (4.5 mg) application to the skin around the nipple-areolar complex from August 2015 to January 2017, while 21 received fusidic acid ointment from March 2012 to August 2015. The number of patients who experienced necrosis of the breast skin flap was counted in both groups. Results Skin flap necrosis developed in 2 (3.8%) patients who were treated with nitroglycerin ointment and 5 (23.8%) patients who did not receive nitroglycerin ointment treatment. Patients who did not receive nitroglycerin ointment treatment had a significantly higher risk of mastectomy skin flap necrosis than patients who did (odds ratio= 7.81; 95% confidence interval, 1.38 to 44.23; P= 0.02). Conclusions Low-dose nitroglycerin ointment administration significantly decreased the rate of skin flap necrosis in patients who underwent breast reconstruction after skin-sparing or nipple-sparing mastectomy, without increasing the incidence of the side effects of nitroglycerin.

KW - Flap

KW - Necrosis

KW - Nitroglycerin

KW - Ointments

KW - Skin

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U2 - 10.5999/aps.2017.00934

DO - 10.5999/aps.2017.00934

M3 - Article

AN - SCOPUS:85052232248

VL - 44

SP - 509

EP - 515

JO - Archives of Plastic Surgery

JF - Archives of Plastic Surgery

SN - 2234-6163

IS - 6

ER -