The use of Topical Dimethyl Sulfoxide (DMSO) in plastic and reconstructive surgery: a narrative review

Dimethyl sulfoxide (DMSO) is a well-known organic solvent that possesses a wide spectrum of properties. DMSO has been shown to possess vasodilative and antioxidative properties as well as increase tissue oxygenation. The use of DMSO in the clinical setting for skin and flap perfusion is not well reviewed or understood. The aim of this article is to review the current use of DMSO and its potential role in improving reconstructive outcomes.

Publications on the use of DMSO in plastic and reconstructive surgery were collected from the PubMed, OVID, Scopus, Embase and Google Scholar databases. MeSH terms related to DMSO, topical DMSO, skin flaps, wound healing, graft preservation, reconstructive and plastic surgery were used to conduct this search. Recent relevant studies were reviewed.

Data on DMSO’s effect on flap perfusion, wound healing, tissue expansion, and fat graft tissue were investigated. Results revealed improvement in skin flap survival, preservation of fat graft tissue, enhanced skin expansion, and significant stimulation of the wound healing process.

This review highlights the therapeutic effects of topical DMSO in clinical and animal studies. The use of DMSO on threatened or poorly perfused skin has promising results and may be an additional adjunct. Further studies should highlight the mechanism of its action as well as compare DMSO to nitroglycerin-containing paste, a more commonly used agent by plastic surgeons.

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