the purpose of this study was to investigate the effect of electrical stimulation on ischemia-induced tissue injury in skin flaps. bipedicle skin flaps measuring 4 x 20 cm were created bilaterally on the flanks of 12 yorkshire pigs. the ischemic central portions of the flaps were treated with 35 ma of electrical current at a frequency of 128 hz for 30 minutes twice daily during the initial nine days following skin-flap elevation. the treatment schedule consisted of negative-electrode stimulation during the first three days, positive-electrode stimulation during the second three days, and negative-electrode stimulation during the seventh to ninth days. five control pigs underwent either no treatment (n = 3) or sham treatment (n = 2). the mean area of the skin flaps exhibiting necrosis was 28.0% in the control animals and 13.2% in the stimulated animals. these areas were significantly different (p < .001). the results indicate that pulsed electrical stimulation can improve the survival of skin flaps.