Cilostazol Improves Wound Healing in Patients Undergoing Open Bypass for Ischemic Tissue Loss: A Propensity Score Matching Analysis

Ann Vasc Surg. 2018 May:49:30-38. doi: 10.1016/j.avsg.2017.11.039. Epub 2018 Feb 15.


Background: Few reports have described the effects of medication on the wound healing of ischemic ulcers after revascularization. This study was conducted to investigate the effects of cilostazol on wound healing in patients who underwent infrainguinal bypass for ischemic tissue loss.

Methods: Two hundred sixty-three limbs undergoing de novo infrainguinal bypass for tissue loss from January 2004 to December 2015 were divided into 2 groups based on whether or not cilostazol was administered after surgery. The end point was wound healing. The 1-year outcomes of the groups were analyzed using the Kaplan-Meier method, and a propensity score matching analysis was performed to examine the effects of cilostazol on wound healing. In addition, the significant predictors were determined using a Cox proportional hazards regression analysis.

Results: Sixty-one and 202 limbs were included in the cilostazol and non-cilostazol group, respectively. The cilostazol group showed superior wound healing to the non-cilostazol group (cilostazol versus non-cilostazol, 1-year wound healing rate: 92% vs. 81%; median wound healing time: 45 vs. 78 days, P = 0.002). The results of the cilostazol group remained superior after a propensity score matching (cilostazol versus non-cilostazol, 1-year wound healing rate: 95% vs. 83%; median wound healing time: 45.5 vs. 57 days, P = 0.048). A Cox proportional hazards regression analysis indicated that foot infection, Rutherford classification, diabetes mellitus, coronary artery disease, angiosome, the administration of cilostazol, and graft patency were significant factors that influenced wound healing.

Conclusions: The postoperative use of cilostazol help to promote wound healing after open surgery.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Arteriosclerosis Obliterans / diagnosis
  • Arteriosclerosis Obliterans / physiopathology
  • Arteriosclerosis Obliterans / surgery*
  • Blood Vessel Prosthesis Implantation* / adverse effects
  • Cilostazol
  • Databases, Factual
  • Female
  • Humans
  • Ischemia / diagnosis
  • Ischemia / physiopathology
  • Ischemia / surgery*
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Phosphodiesterase 3 Inhibitors / adverse effects
  • Phosphodiesterase 3 Inhibitors / therapeutic use*
  • Propensity Score
  • Proportional Hazards Models
  • Retrospective Studies
  • Risk Factors
  • Tetrazoles / adverse effects
  • Tetrazoles / therapeutic use*
  • Time Factors
  • Tissue Survival
  • Treatment Outcome
  • Vascular Patency
  • Veins / transplantation*
  • Wound Healing / drug effects*


  • Phosphodiesterase 3 Inhibitors
  • Tetrazoles
  • Cilostazol