Efficacy of topical sildenafil formulations in enhancing wound healing outcomes: a narrative review

Abstract

Sildenafil, a major phosphodiesterase type 5 (PDE5) inhibitor, is particularly known for treating erectile dysfunction. It has been suggested as a promising therapeutic medication for accelerating wound healing. This study aimed to summarize the efficacy of different formulations and dosages of sildenafil in enhancing wound healing, focusing on its formulations, dosages, and mechanisms of action. The study used relevant keywords to review studies involving animal models and human patients. No time limitation was considered in the current study. The outcomes measured included re-epithelization, vascularization, collagen formation, and overall healing efficacy. Topical sildenafil formulations indicated significant improvements in wound closure, vascularization, and collagen regeneration in skin wounds. A combination of platelet-rich plasma (PRP) and sildenafil increased skin wound healing. Different concentrations (topical 2% and 5% formulation, and 13 mg/kg orally) were useful, with specific dosages showing significant improvements in healing biomarkers. The underlying mechanisms of sildenafil for accelerating wound healing are increasing nitric oxide (NO) levels and collagen synthesis. Moreover, sildenafil triggers angiogenesis, and fibroblast migration and contributes to skin tissue repair and regeneration. Topical sildenafil can be a promising drug for increasing wound healing, with different formulations and dosages illustrating efficacy in improving healing outcomes. Since sildenafil is a cost-efficient, and readily available drug with few side effects, we suggest further research to optimize its use in clinical settings.

Graphical abstract