Review: ischaemia-reperfusion injury in flap surgery

Ischaemia-reperfusion injury is the mechanism underlying (partial) flap toss. This is not only a traumatic event for the patient, it also causes increased patient morbidity [Kerrigan CL, Stotland MA. Ischemia reperfusion injury: a review. Microsurgery 1993; 14:165-75] as well as prolonged hospitalisation, increasing medical consumption and costs. For surgeons who perform flap surgery, it is important to have knowledge of ischaemia-reperfusion injury in order to prevent it. In this article, an update on the recent research on ischaemia-reperfusion is given. The production of reactive oxygen species, neutrophil influx, depletion of NO and apoptosis are discussed as well. (C) 2009 Published by Elsevier Ltd on behalf of British Association of Plastic, Reconstructive and Aesthetic Surgeons.