Pharmacologic Enhancement of Random Skin Flap Survival by Prostaglandin E2

This study evaluated the effect of prostaglandin E2 on skin flap survival in the porcine model. Dorsal random skin flaps on hypopigmented 15- to 25-kg pigs were used. Prostaglandin E2 (10 ng/kg per minute) was infused for 2 days prior to surgery and continued during the 7-day postoperative period. Mean flap survival was 52.58% +/- 3.62% for the control group and 68.51% +/- 3.34% for the experimental group (P < .05). A moderate correlation existed between prostaglandin E2 serum levels and flap viability. A strong correlation was noted between red blood cell flexibility and the amount of flap survival (r = .86). As red blood cell flexibility increased, the survival percentage also increased. Although prostaglandin E2 reduced adenosine diphosphate-induced platelet aggregation from a baseline of 86.08% +/- 8.33% to 54.61% +/- 17.21%, no correlation was noted between the amount of platelet aggregation and percent flap survival (r = .52).