Introduction:　Many　pathways　have　been　reported　involving　the　effect　of　hydrogen-rich　saline　on　protecting　skin　flap　partial　necrosis　induced　by　the　inflammation　of　ischemia/reperfusion　injury.　This　study　focused　on　the　influence　of　hydrogen-rich　saline　treatment　on　apoptosis　pathway　of　ASK-1/JNK　and　Bcl-2/Bax　radio　in　I/R　injury　of　skin　flaps.　Methods:　Adult　male　Sprague-Dawley　rats　were　divided　into　three　groups.　Group　1　was　sham　surgery　group,　Group　2　and　3　were　ischemia/reperfusion　surgery　treated　with　physiological　saline　and　hydrogen-rich　saline　respectively.　Blood　perfusion　of　flap　was　measured　by　Laser　doppler　flowmeters.　Hematoxylin　and　eosin　staining　was　used　to　observe　morphological　changes.　Early　apoptosis　in　skin　flap　was　observed　through　TUNEL　staining　and　presented　as　the　percentage　of　TUNEL-positive　cells　of　total　cells.　pASK-1,　pJNK,　Bcl-2　and　Bax　were　examined　by　immunodetection.　In　addition　Bcl-2,　Bax　and　caspase-3　were　detected　by　qPCR.　Caspase-3　activity　was　also　measured.　Results:　Compared　to　the　Group　2,　tissues　from　the　group　3　were　observed　with　a　high　expression　of　Bcl-2　and　a　low　expression　of　pASK-1,　pJNK,　and　Bax,　a　larger　survival　area　and　a　high　level　of　blood　perfusion.　Hydrogen-rich　saline　ameliorated　inflammatory　infiltration　and　decreased　cell　apoptosis.　Conclusion:　The　results　indicate　that　hydrogen-rich　saline　could　ameliorate　ischemia/reperfusion　injury　and　improve　flap　survival　rate　by　inhibiting　the　apoptosis　factor　and,　at　the　same　time,　promoting　the　expression　of　anti-apoptosis　factor.　(C)　2015　Published　by　Elsevier　Ltd　on　behalf　of　British　Association　of　Plastic,　Reconstructive　and　Aesthetic　Surgeons.