背景:辐射诱导的溃疡是放疗后用于癌症治疗的晚期皮肤反应。
目的:本研究检查了使用单阶段重建程序来处理与辐射有关的伤口。
方法:9例放射性慢性溃疡伴严重并发症患者入院,重建,2015年10月至2019年9月期间,越南国立烧伤医院再生中心。患者的年龄范围为49至77岁。并发症包括骨外露(n=1),暴露气管(n=1),暴露的颈动脉(n=2),暴露的腋窝动脉(n=2),胸膜外露(n=1),和暴露的心包(n=2)。清创术后用于实现缺陷覆盖的皮瓣类型对每位患者进行个体化治疗,并包括ALT,LD,SCA,和DIEP襟翼。此外,使用高密度聚乙烯重建气管,以恢复暴露气管的患者的呼吸功能。
结果:所有皮瓣均获得完全存活。最重要的器官(气管,腋窝动脉,和颈动脉)被覆盖。住院时间为15至120天。
结论:严重并发症患者的成功治疗表明,立即单阶段重建可能是治疗放射性溃疡的一个有价值的选择。
Radiation-induced ulceration is a late-stage skin reaction after RT for cancer treatment.
The present study examined the use of a single-stage reconstructive procedure to manage radiation-related wounds.
Nine patients with radiation-induced chronic ulcer with accompanying severe complications were admitted to the Plastic, Reconstructive, and Regenerative Center of Viet Nam National Burn Hospital between October 2015 and September 2019. The patients ranged in age from 49 to 77 years. Complications included exposed cheekbone (n = 1), exposed trachea (n = 1), exposed carotid artery (n = 2), exposed axillary artery (n = 2), exposed pleura (n = 1), and exposed pericardium (n = 2). Flap type used to achieve defect coverage after debridement was individualized to each patient and included ALT, LD, SCA, and DIEP flaps. Additionally, a high-density polyethylene was used to reconstruct the trachea to recover breathing function in the patient with exposed trachea.
Complete survival of all flaps was achieved. Most vital organs (the trachea, axillary artery, and carotid artery) were covered. Hospital length of stay ranged from 15 to 120 days.
The successful management of patients with severe complications suggests that immediate single-stage reconstruction may be a valuable option for managing radiation-induced ulcers.