The Evaluation of Pharmacologic Agents on Composite Graft Survival

This study assessed the efficacy of various pharmacologic agents in improving composite graft viability in 60 New Zealand white rabbits given bilateral auricular composite grafts. Treatments included methylprednisolone preoperatively and for 3 days postoperatively or for 7 days postoperatively only; chlorpromazine, dimethylsulfoxide, or superoxide dismutase preoperatively; or indomethacin preoperatively and for either 3 or 7 days postoperatively. Four treatment modalities yielded a statistically significant decrease in percentage of necrosis. Methylprednisolone, when given preoperatively and continued postoperatively, produced the greatest increase (77%) in composite graft tissue survival. Dimethylsulfoxide, chlorpromazine, and indomethacin for 3 days were also effective, but to a much lesser extent. It is speculated that these agents may help stabilize cell membranes during the anoxic phase of plasmic imbibition and minimize cellular edema until revascularization can occur.