Protective effect of hydrogen-rich saline on ischemia/reperfusion injury in rat skin flap
Zhao L, Wang YB, Qin SR, Ma XM, Sun XJ, Wang ML, Zhong RG. · Journal of Zhejiang University Science B. 2013;14(5):382-391.
What kind of evidence is this?
Preclinical
Randomized four-group rat skin-flap dose-comparison experiment
Skin, wound and aging research
Other forms
Not reported in this record.
Not reported in this record.
Methods at a glance
Sixty male Sprague-Dawley rats with abdominal epigastric skin flaps exposed to three hours of vascular occlusion and reperfusion.
60 rats randomized equally to sham, ischemia/reperfusion plus saline, I/R plus 5 mL/kg H₂-rich saline, or I/R plus 10 mL/kg H₂-rich saline, n=15 each.
Single dose before reperfusion; acute perfusion was followed for three hours and flap survival, perfusion, histology and biomarkers were assessed on postoperative day 5.
A single intraperitoneal H₂-rich saline injection of 5 or 10 mL/kg, ten minutes before reperfusion.
H₂ dissolved in normal saline — H₂ only, not Brown's gas.
H₂ was dissolved for six hours at 0.4 MPa; freshly prepared weekly H₂-rich saline was maintained above 0.6 mmol/L.
Not applicable — intraperitoneal saline, not gas inhalation.
No O₂ was co-delivered as part of the intervention.
Sham surgery and ischemia/reperfusion with 5 mL/kg ordinary saline, plus 5 versus 10 mL/kg H₂-rich saline.
Outcomes and reported result
Tissue H₂ concentration, flap survival area, laser-speckle perfusion, histology/inflammatory infiltration, MDA and a multiplex cytokine panel.
Both H₂-rich-saline doses improved flap survival, day-5 perfusion and inflammatory/oxidative measures versus saline. Day-5 perfusion did not differ significantly between 5 and 10 mL/kg, solution pH did not differ from saline, and RANTES was the reported cytokine exception. Perfusion during the three-hour occlusion did not differ among operative groups.
The complete free PMC article was checked for all four groups, H₂ preparation/concentration, both doses, tissue H₂ measurements, positive and null outcomes, funding and conflict declaration.
A reported association, difference or mechanism is not automatically a clinical benefit. Null findings, outcome type, study design and precision all matter.
Cautions and applicability
Preclinical flap model, single pre-reperfusion dose, five-day follow-up, multiple surrogate and cytokine endpoints, and no comparison with standard reconstructive-surgery measures. Beijing Natural Science Foundation support was reported; authors declared no conflicts.
Surgically created skin-flap ischemia/reperfusion in male rats; it does not establish improved human flap survival.
Not reported in this record.
Not reported in this record.
Not reported in this record.
No single-study GRADE certainty rating is assigned. Certainty is assessed by important outcome across a complete eligible evidence set, not by attaching a final grade to one source.
Sources and record status
PMID: 23645175 · DOI: 10.1631/jzus.B1200317
Free full article in PubMed Central.
Complete PMC article and PubMed metadata; full-text extraction checked 9 August 2026.
2026-08-10