Wei KC, Yang KC, Chen LW, Liu WC, Chen WC, Chiou WY, Lai PC, et al.
Scientific reports. Date of publication 2016 Oct 21;volume 6():35875.
1. Sci Rep. 2016 Oct 21;6:35875. doi: 10.1038/srep35875.
Management of fluoroscopy-induced radiation ulcer: One-stage radical excision and
immediate reconstruction.
Wei KC(1)(2), Yang KC(3)(4), Chen LW(3)(4), Liu WC(3)(4), Chen WC(5)(6), Chiou
WY(7), Lai PC(8).
Author information:
(1)Department of Dermatology, Kaohsiung Veterans General Hospital, Taiwan.
(2)Faculty of Yuhing Junior College of Health Care and Management, Kaohsiung,
Taiwan.
(3)Department of Plastic and Reconstructive Surgery, Kaohsiung Veterans General
Hospital, Kaohsiung, Taiwan.
(4)National Yang-Ming University School of Medicine, Taipei, Taiwan.
(5)Department of Dermatology and Allergy, Technische Universität München, Munich,
Germany.
(6)IZZ-Immunologie Zentrum Zürich, Zürich, Switzerland.
(7)Department of Radiation Oncology, Buddhist Dalin Tzu-Chi Hospital, Chiayi,
Taiwan.
(8)Department of Nephrology, Kidney Center, Chang Gung Memorial Hospital, Chang
Gung School of Medicine, Chang Gung University, Linkou, Taiwan.
With increasing use of cardiac fluoroscopic intervention, the incidence of
fluoroscopy-induced radiation ulcer is increasing. Radiation ulcer is difficult
to manage and currently there are no treatment guidelines. To identify the
optimal treatment approaches for managing cardiac fluoroscopy-induced radiation
ulcers, we retrospectively reviewed medical records of 13 patients with
fluoroscopy-induced radiation ulcers receiving surgical interventions and
following up in our hospital from 2012 to 2015. Conventional wound care and
hyperbaric oxygen therapy were of little therapeutic benefit. Twelve patients
received reconstruction with advancement flap or split thick skin graft.
One-stage radical excision of radiation damaged area in eight cases with
immediate reconstruction led to better outcomes than conservative excisions in
four cases. Radical surgical excision to remove all the radiation damaged tissues
in combination with immediate reconstruction appears to offer the optimal
treatment results for cardiac fluoroscopy-induced radiation ulcers. Adequate
excision of the damaged areas in both vertical (to the muscular fascia) and
horizontal (beyond the sclerotic areas) dimension is pivotal to achieve good
treatment outcomes.
DOI: 10.1038/srep35875
PMCID: PMC5073289
PMID: 27767187 [Indexed for MEDLINE]
