Ischemia/Reperfusion: A Potential Cause of Tissue Necrosis

Ischemia/reperfusion injury (IRI) is a process of injury after revascularized acute ischemic organ. In musculoskeletal tissue, IRI can mostly be found in acute limb ischemia and free-flap transfer. There are two phases of injuries, ischemic and reperfusion phases. Damages of IRI are more severe in the reperfusion phase, which involves oxidative stress and inflammatory responses. Effects of reperfusion can be either local effect or systemic effect. Local effects are tissue edema, compartment syndrome, and tissue necrosis. Systemic effects can range from remote organ injury to multi-organ failure. There are many interventions, which prevent tissue from IRI, investigated in vitro, in vivo, and clinically. Lots of promising outcomes are not yet investigated in humans. Further clinical study should be conducted in IRI prevention.