Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Experiment Video

Updated: Jun 16, 2026

A Pre-clinical Rat Model for the Study of Ischemia-reperfusion Injury in Reconstructive Microsurgery
08:05

A Pre-clinical Rat Model for the Study of Ischemia-reperfusion Injury in Reconstructive Microsurgery

Published on: November 8, 2019

Cold ischemia in microvascular breast reconstruction.

David T Lee1, Gordon Lee

  • 1Stanford Plastic and Reconstructive Surgery, Stanford University, Palo Alto, CA 94304-5715, USA.

Microsurgery
|February 11, 2010
PubMed
Summary

Introducing cold ischemia in microvascular free flap breast reconstruction allows surgical teams brief rests, reducing fatigue. This technique is safe and well-tolerated by flaps, with complications inversely related to ischemia time.

Related Concept Videos

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

Predicting Surgical Outcomes in Breast Reconstruction With Machine Learning: A Systematic Review.

Annals of plastic surgery·2026
Same author

Is Malignancy Associated With Arthroplasty? A Meta-analysis.

Clinical orthopaedics and related research·2025
Same author

Implant-associated malignancies in the genitourinary system: a comprehensive review of evidence and gaps.

International urology and nephrology·2025
Same author

Analyzing outcomes after proximal humerus fractures in patients <65 years: a systematic review and meta-analysis.

JSES reviews, reports, and techniques·2023
Same author

Artificial intelligence for predicting hearing improvement after myringoplasty: a pilot study.

Singapore medical journal·2023
Same author

T-Line mesh as a safe and effective option for abdominal wall reinforcement with autologous breast reconstruction.

Journal of plastic, reconstructive & aesthetic surgery : JPRAS·2023

Area of Science:

  • Plastic Surgery
  • Surgical Innovation
  • Oncology

Background:

  • Microvascular free flap breast reconstruction can involve lengthy operations, up to 9 hours, causing surgeon fatigue.
  • Surgeon fatigue during prolonged procedures may negatively impact surgical outcomes.
  • A period of cold ischemia for flaps can facilitate surgeon rest periods during reconstruction.

Purpose of the Study:

  • To evaluate the safety and efficacy of incorporating cold ischemia periods in microvascular free flap breast reconstruction.
  • To assess the impact of cold ischemia on complication rates and flap viability.
  • To determine if cold ischemia can mitigate surgeon fatigue during bilateral breast reconstruction.

Main Methods:

  • Retrospective review of microvascular free flap breast reconstructions over a four-year period.

More Related Videos

Dynamic Assessments of Coronary Flow Reserve after Myocardial Ischemia Reperfusion in Mice
05:07

Dynamic Assessments of Coronary Flow Reserve after Myocardial Ischemia Reperfusion in Mice

Published on: August 25, 2023

Related Experiment Videos

Last Updated: Jun 16, 2026

A Pre-clinical Rat Model for the Study of Ischemia-reperfusion Injury in Reconstructive Microsurgery
08:05

A Pre-clinical Rat Model for the Study of Ischemia-reperfusion Injury in Reconstructive Microsurgery

Published on: November 8, 2019

Dynamic Assessments of Coronary Flow Reserve after Myocardial Ischemia Reperfusion in Mice
05:07

Dynamic Assessments of Coronary Flow Reserve after Myocardial Ischemia Reperfusion in Mice

Published on: August 25, 2023

  • Analysis of cases where cold ischemia was intentionally induced in the flaps.
  • Documentation of cold ischemia times, surgeon rest times, and postoperative complications.

    • Main Results:

    • 104 flaps were used in 70 patients, with a mean cold ischemia time of 2 hours 36 minutes.
    • Average surgeon rest time per case was 35 minutes.
    • Low complication rates were observed: 1.9% total flap loss, 1.0% partial flap loss, 1.0% anastomotic thrombosis, 1.9% hematomas, 2.9% fat necrosis, and 1.9% delayed healing. Complication probability was inversely related to cold ischemia time (P = 0.0163).

    Conclusions:

    • Cold ischemia allows for necessary surgical team breaks, reducing fatigue during lengthy breast reconstruction procedures.
    • The use of cold ischemia is well-tolerated by the microvascular flaps.
    • Cold ischemia is a safe and advantageous technique in microvascular breast reconstruction, potentially improving surgical outcomes by mitigating fatigue.