Skeletal muscle reperfusion injury: pathophysiology and clinical considerations

Skeletal muscle reperfusion injury following revascularization of an acutely ischaemic limb undoubtedly contributes to the morbidity and mortality of this surgical emergency. This article reviews the experimental evidence which has defined the biochemical events responsible for the pathogenesis of this injury, with particular emphasis on the roles played by free radicals, neutrophils and products of lipid peroxidation. Finally, the clinical relevance of both the local and systemic effects of the injury is considered, together with suggestions for potential therapeutic strategies based on the results of laboratory work.