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South African Journal of Surgery

versão On-line ISSN 2078-5151
versão impressa ISSN 0038-2361

S. Afr. j. surg. vol.48 no.4 Cape Town Nov. 2010




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



Suat KutunI; Ay Aybala AgacI; Haluk UlucanlarI; Oguz TarcanI; Ahmet AyI; Mete AldanII; Guven GorkemIII; Abdullah DemirIV; Abdullah CetinV

IM.D.; Department of General Surgery, Ankara Oncology Research and Training Hospital, Turkey
IIM.D.; Ankara Research and Education Hospital, Turkey
IIIM.D.; Ankara Bilgi Hospital, Turkey
IVM.D.; Department of General Surgery, Ankara Oncology Research and Training Hospital

VM.D.; Ph.D. Department of General Surgery, Ankara Oncology Research and Training Hospital




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, 6 426 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.



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