Original Research Article
Year: 2020 | Month: August | Volume: 7 | Issue: 8 | Pages: 335-343
Mastectomy Flap Necrosis: The Role of Cilostazol in Prevention
Mriganka Ghosh1, Dipayan Sen2, Soumita Ghosh Sengupta3, Chandan Roy Choudhury4
1Associate Professor, Dept. Of General Surgery, Medical College and Hospital, Kolkata.
2Senior Resident, Sramajibi COVID Hospital.
3Associate Professor of Pathology, College of Medicine & Sagore Dutta Hospital, Kamarhati, Kolkata
4Professor & HOD, Dept. Of General Surgery, Murshidabad Medical College & Hospital, Berhampur.
Corresponding Author: Mriganka Ghosh
ABSTRACT
Flap necrosis in post mastectomy patient, either partial or full is a serious complication of breast cancer surgery. While in developed countries, it mostly follows skin sparing or nipple sparing mastectomy or mastectomy with immediate reconstruction, in India, MRM is the main perpetrator. It brings forth a number of problems like wound problems, delay in adjuvant therapy, anxiety and unanticipated financial burden. Talking of solution, prevention is the best and adoption good surgical practice including good tissue respect and avoidance of certain traumatic techniques can minimise the incidence. But once happened, wound can be managed both operatively and non-operatively. Cilostazol, a selective inhibitor of cellular phosphodiesterase type 3 (PDE3) is known to improve blood supply, especially in the microcirculation and also promotes cutaneous oxygen supply. With an aim to determine its role in prevention and management of Mastectomy Skin Flap Necrosis (MSFN), we conducted a study over a meticulously selected 60 patients of Carcinoma breast, slated for modified radical mastectomy (MRM), randomly divided them into two groups of 30 each, one group received Cilostazol, at a dose of 100mg orally twice daily for 1 month, starting from first post-operative day, while the other group did not. It showed that Cilostazol significantly reduced the incidence of flap necrosis in our study population (p=0.032 with little side effects. Hence, Cilostazol can be recommended as a safe and efficacious post-operative drug in all cases of MRM, especially in high risk patients, to reduce the incidence of flap necrosis.
Keywords: MRM, Mastectomy Skin Flap Necrosis (MSFN), Cilostazol
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