PDF(Pubmed)
Abstract：
Ulcer in radiation-damaged tissue is a dilemma with limited treatment strategies. The study aimed to evaluate the safety and efficacy of regional flaps for patients with post-radiation ulcers through a 10-year experience. A retrospective study of consecutive patients with post-radiation ulcers at a single institute from 2012 to 2022 was conducted. Reconstruction included complete excision of irradiated tissue and coverage with well-vascularised tissue, including local flaps, regional flaps and free flaps. Study outcomes included complications, reoperation rates, overall flap success and recurrence rates. Thirteen patients (six males and seven females; mean age, 56.85 ± 13.87 years) with a mean 10-month history of post-radiation ulcers were enrolled. Ulcers are predominantly located in the chest (n = 3, 23.1%), head (n = 2, 15.4%) and neck (n = 2, 15.4%), with a mean size of 33.1 cm2 (range from 1 cm2 to 120 cm2 ). Eleven patients underwent reconstruction with 15 regional flaps and three local flaps, one patient received a free anterolateral thigh fasciocutaneous flap and one patient underwent amputation. Among these 15 regional flaps, one (6.7%) had wound dehiscence and four (26.7%) had localised necrosis requiring reoperation. In addition, one patient with a non-healing sinus tract underwent reoperation. The overall success rate of the regional flap was 100% and no recurrence was observed with a mean follow-up of 23.3 months. Regional flaps seem a safe and effective reconstructive method for post-radiation ulcers.
摘要：
放射性损伤组织中的溃疡是治疗策略有限的困境。该研究旨在通过10年的经验评估局部皮瓣对放射后溃疡患者的安全性和有效性。对2012年至2022年在单个研究所连续的放射后溃疡患者进行了回顾性研究。重建包括完全切除受照射的组织和覆盖血管良好的组织，包括局部皮瓣,区域皮瓣和自由皮瓣。研究结果包括并发症，再操作率,整体皮瓣成功率和复发率。13名患者（男性6名，女性7名；平均年龄，56.85±13.87年），平均有10个月的放射后溃疡史。溃疡主要位于胸部（n=3，23.1%），头部（n=2，15.4%）和颈部（n=2，15.4%），平均尺寸为33.1cm2（范围从1cm2到120cm2）。11例患者接受了15个区域皮瓣和3个局部皮瓣的重建，1例患者接受了游离股前外侧筋膜皮瓣，1例患者接受了截肢。在这15个区域襟翼中，1例（6.7％）伤口裂开，4例（26.7％）局部坏死，需要再次手术。此外,1例窦道不愈合的患者接受了再次手术.区域皮瓣的总成功率为100％，无复发，平均随访23.3个月。局部皮瓣似乎是治疗放射后溃疡的一种安全有效的重建方法。
