Skin　damage　induced　by　ischemia/reperfusion　(I/R)　is　a　multifactorial　process　that　often　occurs　in　plastic　surgery.　The　mechanisms　of　I/R　injury　include　hypoxia,　inflammation,　and　oxidative　damage.　Hydrogen　gas　has　been　reported　to　alleviate　cerebral　I/R　injury　by　acting　as　a　free　radical　scavenger.　Here,　we　assessed　the　protective　effect　of　hydrogen-rich　saline　(HRS)　on　skin　flap　I/R　injury.　Abdominal　skin　flaps　of　rats　were　elevated　and　ischemia　was　induced　for　3　h;　subsequently,　HRS　or　physiological　saline　was　administered　intraperitoneally　10　min　before　reperfusion.　On　postoperative　Day　5,　flap　survival,　blood　perfusion,　the　accumulation　of　reactive　oxygen　species　(ROS),　and　levels　of　cytokines　were　evaluated.　Histological　examinations　were　performed　to　assess　inflammatory　cell　infiltration.　Skin　flap　survival　and　blood　flow　perfusion　were　improved　by　HRS　relative　to　the　controls.　The　production　of　malondialdehyde　(MDA),　an　indicator　of　lipid　peroxidation,　was　markedly　reduced.　A　multiplex　cytokine　assay　revealed　that　HRS　reduced　the　elevation　in　the　levels　of　inflammatory　cytokines,　chemokines　and　growth　factors,　with　the　exception　of　RANTES　(regulated　on　activation,　normal　T-cell　expressed　and　secreted)　growth　factor.　HRS　treatment　also　reduced　inflammatory　cell　infiltration　induced　by　I/R　injury.　Our　findings　suggest　that　HRS　mitigates　I/R　injury　by　decreasing　inflammation　and,　therefore,　has　the　potential　for　application　as　a　therapy　for　improving　skin　flap　survival.