Nitric oxide(NO) relaxes thevascular smooth muscle of blood vessels, increases blood flow perfusion, and protects tissues from ischemia-reperfusion injury(IRI). Hypoxic and low pH conditions favor the production of NO fromnonenzymatic pathways to protect the flap tissue from IRI. This article focuses on the relationship between IRI of free skin flap and nitric oxide and presents the latest research on nonenzymatic NO-producing pathways and their role in the IRI of the free skin flap. This paper also investigates the value of these pathwaysin preventing IRI in flaps and provides the oretical bases and new ideas preventing and treating IRI.
