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Abstract
Various pharmacological agents have been used to try and elucidate the pathophysiology of ischaemia and necrosis of flaps. Their most important disadvantage is the need for relatively high doses given systemically, which increases the risk of potential side effects. Topical or local agents are more useful. Sildenafil citrate, the specific inhibitor of cyclic guanosine monophosphate (cGMP)-specific phosphodiesterase type 5 (PDE 5) was studied as an antianginal drug during the late 1980s, but is now used for its effect on erectile function in men. Sildenafil citrate causes dilatation of peripheral arteries and veins and the inhibition of the thrombus-forming ability of platelets in vivo. Our study was designed to test the efficacy of sildenafil citrate on the viability of flaps.