Tóm tắt
Objectives: To evaluate the effectiveness of plastic surgery in the treatment of chronic radiation-induced ulcer. Subjects and methods: A interventional, prospective study was conducted on 24 patients with chronic radiation-induced ulcer, treated in National Institute of Burns from 10/2013 to 9/2017. Results: Among 24 patients, there were 5 males and 19 females, mean age 56 ± 14.57. The most common wound was in the thoracic region (12 patients = 50%), 6 patients (25%) had head and neck wounds. The mean size of the soft tissue defects varied 93.8 ± 76.5 cm2. There was a total of 26 flaps including 5 local flaps, 8 pedicle flaps, 11 perforator flaps, 1 tissue expander and 1 free flap. The latissimus dorsi musculocutaneous flap and gluteal perforator artery fasciocutaneous flap were used in the majority of these cases. The donor site was primarily closed in 8 patients, 12 patients required a skin graft. The survival rate of flaps was up to 92.4%. The overall rate of local complications was 50%, there was one patient with partial flap necrosis, one patient with completely necrotized flap. Wound healing: 22 patients, non-healing: 2 patients, no cases of recurrent ulcer were found. Conclusion: Plastic surgery in the treatment of chronic radiation-induced ulcers needed removal both of ulcer and infiltration area. Using flap after removal of the lesion is the only treatment, of which the chosen flaps need to be large enough and good blood supply. * Keywords: Radiation injury; Surgical reconstruction; Chronic radiation-induced ulcer.
Abstract
Objectives: To evaluate the effectiveness of plastic surgery in the treatment of chronic radiation-induced ulcer. Subjects and methods: A interventional, prospective study was conducted on 24 patients with chronic radiation-induced ulcer, treated in National Institute of Burns from 10/2013 to 9/2017. Results: Among 24 patients, there were 5 males and 19 females, mean age 56 ± 14.57. The most common wound was in the thoracic region (12 patients = 50%), 6 patients (25%) had head and neck wounds. The mean size of the soft tissue defects varied 93.8 ± 76.5 cm2. There was a total of 26 flaps including 5 local flaps, 8 pedicle flaps, 11 perforator flaps, 1 tissue expander and 1 free flap. The latissimus dorsi musculocutaneous flap and gluteal perforator artery fasciocutaneous flap were used in the majority of these cases. The donor site was primarily closed in 8 patients, 12 patients required a skin graft. The survival rate of flaps was up to 92.4%. The overall rate of local complications was 50%, there was one patient with partial flap necrosis, one patient with completely necrotized flap. Wound healing: 22 patients, non-healing: 2 patients, no cases of recurrent ulcer were found. Conclusion: Plastic surgery in the treatment of chronic radiation-induced ulcers needed removal both of ulcer and infiltration area. Using flap after removal of the lesion is the only treatment, of which the chosen flaps need to be large enough and good blood supply. * Keywords: Radiation injury; Surgical reconstruction; Chronic radiation-induced ulcer.