Ischemia/reperfusion injury in microvascular surgery

Ischemia/reperfusion injury Is often the final and irreversible factor caus ing flap failure in microvascular surgery for head and neck defects. This p aper begins with a detailed review of flap physiology and ischemia/reperfus ion injury at the cellular level. Subsequently, the pharmacotherapeutic age nts used clinically and experimentally to avoid or reverse ischemia/reperfu sion injury are discussed. The goal of this review is to provide a framewor k for understanding the expanding body of literature relevant to ischemia/r eperfusion injury in microvascular surgery. (C) 2000 John Wiley & Sons. Inc .