Introduction: The purpose of this study was to investigate the efficacy of stem cell therapy as an adjuvant treatment for congested skin flap.Method: Sprague-Dawley rats(n521)were randomized into three groups.In group Ⅰ,the flap was sutured without venous ischemia.In group Ⅱ,the vein was selectively clamped for 4 hours,and complete medium was administered upon clamp removal.In group Ⅲ,ADSCs were administered upon removing the clamp.On postoperative day 7,the survival areas and the histopathologic findings were assessed.In addition,the expression of heme oxygenase(HO)-1 and nuclear factor(NF)-kB was assessed using immunofluorescent staining and western blot analyses.Results: Compared with group Ⅱ,group Ⅲ showed significantly increased flap survival(31.2%611.9%vs.51.6%613.6%,P<0.05).The degree of histological abnormalities was significantly lower in group Ⅲ than in group Ⅱ(9.38%61.39 vs.6.46%62.57,P<0.05).In addition,in group Ⅲ,the expression of NF-jB was significantly lower(0.5160.21 vs.0.3460.21,P<0.05),whereas that of HO-1 was significantly higher(0.2560.11 vs.0.4360.18,P<0.01).Immunofluorescent staining also showed more HO-1-positive cells in group Ⅲ than in group Ⅱ(10.9%61.6%vs.16.0%61.7%,P<0.01).Conclusion: Our study demonstrated that treatment with ADSCs significantly increased flap survival in venous ischemia-reperfusion conditions.Further investigation of these protective effects and optimization of the treatment protocol could make cell therapy a viable treatment.