Effect of celecoxib on fasciocutaneous flap survival and revascularization

Objectives: To study the effect of celecoxib (Celebrex; Pfizer, Cambridge, Mass) on (1) primary ischemic time and (2) revascularization of fasciocutaneous free flaps in a rat model. Methods: In the ischemia study, 50 male Sprague-Dawley rats were divided into 2 groups of 25 rats each, a control group and a celecoxib group. Five rats in each treatment group were exposed to ischemic times of 4, 6, 8, 10, and 12 hours. Survival of the flap was assessed 7 days after reversal of the ischemia. Probit curves and the critical ischemic time were calculated. In the revascularization study, 30 male Sprague-Dawley rats were divided into 2 groups of 15 rats each. One group was fed celecoxib, while the other was fed a normal diet. All rats had a 3 × 6-cm fasciocutaneous flap based on the inferior epigastric artery elevated and exposed to 2 hours of primary ischemia. The flap was then sutured back into the wound bed. Each of these groups was then divided into 3 groups of 5 rats whose pedicles were divided on postoperative day 5, 6, or 7. Percentage survival of the flap was measured 7 days later. In both parts of the study, the experimental group was fed celecoxib, 1500 ppm, throughout the interoperative period. In each animal, a 3 × 6-cm ventral fasciocutaneous groin flap based on the left superficial epigastric artery was elevated. Results: In the ischemia study, respective flap survival rates from the control and celecoxib groups at the various ischemic times were as follows: 4 hours, 100% and 100%; 6 hours, 80% and 100%; 8 hours, 80% and 80%; 10 hours, 60% and 60%; and 12 hours, 20% and 10%. The median lethal ischemic times were 9.7 and 9.6 hours, respectively. There was no statistical difference in flap survival between the celecoxib and control groups. In the revascularization study, ligation of the flap pedicle on day 5, 6, or 7 did not result in any difference in the percentage of flap survival among the 3 groups. Conclusion: Celecoxib appears to have no deleterious effect on free tissue transfer survival or healing, as evidenced by revascularization in a fasciocutaneous free flap model.