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This fluctuating oxygen tension, combined with iron availability and inflammatory mediators, further amplifies lipid peroxidation potential (95, 96) In reconstruction contexts involving staged procedures—such as the induced membrane technique or serial debridement for infected defects—repeated surgical insults may perpetuate this cycle of ischemia–reperfusion and oxidative stress (97, 98)

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The majority of circulating IGF-1 originates from hepatic cells, and its production and release are controlled by GH [21]