Wz. Wang et Gl. Anderson, Intervention approaches against I/R-induced arterial insufficiency in reconstructive surgery, HAND CLIN, 17(3), 2001, pp. 357
Ischemia and reperfusion in skeletal muscle is unavoidable during many reco
nstructive surgeries. Typical examples include replantation, transplantatio
n, and free muscle transfer. One important complication during or after sur
gery is arterial insufficiency or a no-reflow phenomenon. The microcirculat
ion is a primary target of ischemia and reperfusion injury. Vasoconstrictio
n, poor blood flow, and capillary no-reflow, are the prominent features in
the microcirculation seen during reperfusion. Currently, extensive efforts
have focused on the theory that reactive oxygen species induce endothelial
dysfunction in the microcirculation during reperfusion. Some intervention a
pproaches, including ischemic preconditioning, are developing to interfere
with or modulate the pathophysiological processes that are set in motion du
ring ischemia and reperfusion.