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

Min Ho Yun, Eul Sik Yoon, Byung Il Lee, Seung Ha Park

    Research output: Contribution to journalArticlepeer-review

    9 Citations (Scopus)

    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

    Keywords

    • Flap
    • Necrosis
    • Nitroglycerin
    • Ointments
    • Skin

    ASJC Scopus subject areas

    • Surgery

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