Prevention of wound edge necrosis by local application of dimethylsulfoxide

Abstract

Background: Surgical flap necrosis is one of the most common problems after procedures such as mastectomies and regional lymph node dissections. In this prospective randomized study, the effect of topical dimethylsulfoxide (DMSO) on skin flap viability was analyzed.

Material and methods: Sixty-six consecutive patients with breast cancer who had skin flaps created during mastectomy were randomized into two groups. Topical DMSO was applied on surgical flaps of the patients in Group-1, topical saline was applied for those in Group-2. Necrotic flap edges were recorded during the follow-up period for each patient, then excised and weighted in a blind manner.

Results: The mean weight of flap edge necrosis was 23.48 +/- 9.5 (mean +/- sem) microg in DMSO group and 126.27 +/- 44.8 microg in control group (p = 0.03). The hospitalization period was 9.6 +/- 0.5 days and 11.8 +/- 0.8 days in DMSO group and control group respectively (p = 0.02). There were no side effects due to DMSO.

Conclusion: The application of DMSO reduced skin flap necrosis and improved outcome of surgical flaps.