Perfusion and neuro-functional evaluation of new methods for protection from ischemia–reperfusion injury in microvascular reconstructive post-oncologic surgery

Reconstructive microsurgery allows for autologous tissue transplantation via microvascular anastomosis. The procedure involves temporary ischemia, leading to ischemia–reperfusion (I/R) injury, which contributes to flap complications. While preservation solutions are widely used in organ transplantation, their application in microvascular free flaps remains underexplored. This study evaluates the feasibility and safety of cold preservation using University of Wisconsin (UW) solution to mitigate I/R damage in oncologic microsurgical reconstructions. This study is a randomized controlled trial (RCT) comparing standard care versus cold preservation with UW solution in oncologic reconstructive microsurgery. Participants will be randomly assigned to two groups: group A (flap perfusion with UW solution and cold storage at 4 °C) and group B (no perfusion with UW solution and standard storage at room temperature). Primary outcomes include intraoperative flap perfusion and postoperative complications, while secondary outcomes focus on neurosensory recovery and bone quality for Dental implant integration. The findings of this study could lead to improved outcomes in reconstructive microsurgery by reducing ischemia-related complications. If successful, this technique could be extended to other surgical applications requiring tissue preservation. ClinicalTrials.gov NCT06523920. Registered on 10 October 2025.