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Calcitonin Gene–Related Peptide Treatment of Flaps with Compromised Circulation in Humans

Nineteen patients with surgical or traumatic flaps and one patient with a congenital vein vault deficiency were treated with the vasodilatory compound calcitonin gene–related peptide (CGRP) intravenously. The patients showed compromised circulation due to ischemia and/or venous stasis. In all but three patients, the treatment resulted in an improved tissue circulation, as measured by laser Doppler flowmetry. Thirteen of the flaps survived completely, and in three flaps a partial necrosis was encountered (≤25 percent). The three flaps that did not respond at all to calcitonin gene–related peptide treatment did not survive. Calcitonin gene–related peptide was shown to be much more effective than transcutaneous electrical nerve stimulation (TENS). Thus calcitonin gene–related peptide provides a pharmacologic tool to improve blood flow in surgical and traumatic flaps with compromised circulation in humans.