Chapter 3 Abstract Ischemia‐reperfusion (IR) injury can cause (partial) flap loss. This causes increased patient morbidity, prolongs hospitalization, and depending on the severity of partial flap loss, affects the clinical outcome. This review article summarizes the events during IR injury in (free) tissue transfer, which are basically out of the control of the reconstructive surgeon. Nitric oxide (NO) has been extensively studied regarding its role in IR injury, and this article focuses on the available data on NO and IR injury in surgical flaps and highlights the potential clinical implication of NO aimed at reducing IR injury. 38
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