Reducing reperfusion injury is effective in reducing flap loss after prolonged 
ischemia. Anti-inflammatory therapy reduces reperfusion injury in canine cardiac 
muscle and ex vivo rat cremaster muscle; however, to date, there are no studies 
involving the use of anti-inflammatory agents in ischemic skin flaps. This study 
was designed to assess the effects of dexamethasone and indomethacin on the 
viability of rat island groin flaps subjected to 10 hours of ischemia. The 
ischemic control and the treatment group flaps were subjected to 10 hours of 
ischemia by clamping the inferior epigastric vascular pedicle. The treatment 
groups received either intravenous dexamethasone or intravenous indomethacin 
after the flap vascular pedicles were clamped. Our results showed significant 
improvement (p < 0.05, Fisher's exact test) in ischemic flap survival using 
dexamethasone. The specific mode of action of dexamethasone was not 
investigated; however, its anti-inflammatory effects were most likely 
responsible for the improvement of flap survival by suppressing the circulating 
neutrophil and decreasing reperfusion injury. Dexamethasone is easily available 
for clinical use, and its use should be considered in cases of prolonged 
ischemia in skin flaps.