The effects of a topically applied combination of
nonivamide and
nicoboxil in improving skin perfusion and preventing distal flap
necrosis were tested in a random-pattern dorsal skin flap model. Forty male Wistar rats were randomized into two groups (n = 20), and a standardized dorsal random-pattern skin flap was raised on each rat. Animals in the experimental group were treated with the topically applied
drug combination four times per day for 6 days, whereas in the control group only a placebo
ointment was applied each time. Skin flap viability was evaluated on day 7, and the extent of skin flap
necrosis was compared between the two groups. The topically applied combination of
nonivamide and
nicoboxil resulted in a statistically significant decrease in skin flap
necrosis, compared with the control group (mean percentage of skin flap
necrosis in the
nonivamide/
nicoboxil-treated group, 22.6 +/- 6.0 percent; control group, 36.8 +/- 4.3 percent; p< 0.05). The topical combination of
nonivamide and
nicoboxil was effective in reducing ischemic
necrosis in failing random-pattern skin flaps in this rat model. The results of this study suggest that such a topical
drug application might have significant effects in the reduction of ischemic
necrosis in the distal parts of skin flaps, and this treatment might also have applications as prophylactic
therapy for risky skin flaps.