Islanders center Kyle Palmieri, center, celebrates his goal with right...

Islanders center Kyle Palmieri, center, celebrates his goal with right wing Simon Holmstrom (10) left, and right wing Maxim Tsyplakov (7) right, during the second period of an NHL hockey game against the Buffalo Sabres, Friday, Nov. 1, 2024, in Buffalo. Credit: AP/Jeffrey T. Barnes

BUFFALO — Mathew Barzal is not the Islanders’ only injury concern.

They finished off their 4-3 win over the Sabres on Friday night at KeyBank Center without defensemen Mike Reilly and Adam Pelech. Blueliner Alexander Romanov also missed a few shifts after returning to the lineup. He had been out for three games with an upper-body injury.

“I think it just takes some guts,” defenseman Ryan Pulock said after he logged 24:42, Noah Dobson 24:49, Romanov 23:26 and Scott Mayfield 20:48 as they rotated short shifts. “The four guys, Romy battling, you’ve just got to gut it out. The forwards did a great job of helping us. We were smart with the puck.”

Still, the Islanders (4-5-2), in the middle match of a three-game road trip, snapped a three-game losing streak and earned only their second regulation win behind 32 saves from a sharp Ilya Sorokin. That included denying Jason Zucker’s penalty shot at 5:01 of the third period.

Bo Horvat tied it at 1 on a breakaway at 9:43 of the first period — 40 seconds after Dylan Cozens’ power-play goal opened the scoring — and also set up Jean-Gabriel Pageau’s tip-in goal at 8:08 of the third period that made it 4-2.

“It was a gutsy win by everybody,” Horvat said. “We said before the game that guys were going to have to step up when guys go down, and did we ever tonight.”

The Islanders announced before the game that Barzal had returned to Long Island with an upper-body injury and needed further medical testing. That left Horvat as the only available member of the original top line, with Anthony Duclair suffering a lower-body injury on Oct. 19 and expected to miss four to six weeks.

Then, in a four-minute stretch of the second period, the Islanders nearly lost half their defense corps.

Jordan Greenway’s hard hit on Romanov behind the Islanders’ net sent him to the dressing room at 5:40. He was able to return at 9:45. But Pelech took a wrist shot to the face and exited with a bloody face at 7:07.

Greenway’s shoulder check along the wall upended Reilly, who landed on his head at 9:14. Horvat and several other Islanders immediately started waving frantically for assistance as Reilly lay unmoving on the ice.

A stretcher was summoned, but Reilly, who clearly had been knocked out, eventually was able to wobble to his skates and be helped off the ice.

“I still have a hard time with the call,” coach Patrick Roy said after referees Furman South and Jake Brenk conferred but did not call a penalty on Greenway. “He threw him on the ice and, at that moment, he hurt himself.”

Otherwise, Roy said there were no updates on Pelech or Reilly, though he added that Reilly would be able to travel back to New York City with the team after the game.

“It sucks to see somebody go down like that,” Horvat said. “We’re told he’s doing a lot better and he’s talking.”

Roy said Barzal was injured in Wednesday night’s 2-0 loss in Columbus, though he was able to finish that game.

So Roy was forced to rearrange his lines again, elevating Pageau and Anders Lee to play with Horvat. He also started with Pierre Engvall and Simon Holmstrom on Casey Cizikas’ wings and fourth-line center Kyle MacLean between Hudson Fasching and Oliver Wahlstrom. Only Brock Nelson’s second line with Kyle Palmieri and Max Tsyplakov remained intact.

Tysplakov used his speed to burst around defenseman Connor Clifton for a 2-1 lead at 5:25 of the second period. His deft backhanded feed across the crease set up Kyle Palmieri’s power-play goal to make it 3-1 at 12:20 of the second period.

Zucker’s tip made it 3-2 at 5:27 of the third period and defenseman Owen Power added a six-on-five goal with 1:01 remaining in regulation.

Devon Levi made 32 saves for the Sabres (4-6-1), who could not convert on a 24-second five-on-three early in the second period.

Notes & quotes: Wahlstrom played in his 200th NHL game and fought Zucker at 16:20 of the second period after getting cross-checked. “First off, that’s exhausting,” Wahlstrom said. “I don’t know how Marty [Matt Martin] does that.” ... Defenseman Dennis Cholowski and Martin were the healthy scratches ... The Sabres had won seven straight against the Islanders at home dating to Feb. 16, 2021.

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