Ischemia/reperfusion injury in microvascular surgery.
Ischemia/reperfusion injury is often the final and irreversible factor causing flap failure in microvascular surgery for head and neck defects. This paper begins with a detailed review of flap physiology and ischemia/reperfusion injury at the cellular level. Subsequently, the pharmacotherapeutic agents used clinically and experimentally to avoid or reverse ischemia/reperfusion injury are discussed. The goal of this review is to provide a framework for understanding the expanding body of literature relevant to ischemia/reperfusion injury in microvascular surgery.
Carroll
W R
WR
Division of Otolaryngology-Head and Neck Surgery, University of Alabama at Birmingham, 1501 5th Avenue South, Birmingham, Alabama 35233, USA.
Esclamado
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RM
D004730:Endothelium, Vascular / Q000293:injuries / Q000378:metabolism; D005609:Free Radicals / Q000378:metabolism; D006257:Head / Q000098:blood supply; D006801:Humans; D018836:Inflammation Mediators / Q000378:metabolism; D008866:Microsurgery / Q000009:adverse effects*; D009333:Neck / Q000098:blood supply; D009504:Neutrophils / Q000378:metabolism; D015427:Reperfusion Injury / Q000150:complications / Q000188:drug therapy* / Q000209:etiology* / Q000378:metabolism; D013524:Surgical Flaps / Q000098:blood supply / Q000502:physiology*; D013925:Thromboplastin / Q000037:antagonists & inhibitors; D013927:Thrombosis / Q000188:drug therapy / Q000209:etiology; D014656:Vascular Surgical Procedures / Q000009:adverse effects*
D005609:Free Radicals; D018836:Inflammation Mediators; D013925:Thromboplastin