Pharmacologic manipulation of random skin flaps with pentoxifylline

The literature demonstrates inconsistent results amongst investigators who have used pentoxifylline in an effort to enhance skin flap survival. This study employed a standardized skin flap model in the rat and a standard intraperitoneal dose of pentoxifylline (10 mg/kg) delivered in four different temporal regimens. Fluorescein staining and length of flap survival were measured. The only regimen that demonstrated increased flap survival over saline controls included administration of the drug immediately upon raising the flap and every 12 hours for the next 7 days. Three different regimens that included preoperative administration of the drug failed to demonstrate a beneficial effect on skin flap survival. Slight improvement in flap survival was seen in animals receiving fluorescein. These results suggest an inconsistent pentoxifylline effect even within a single controlled study.