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Management of fluoroscopy-induced radiation ulcer: One-stage radical excision and immediate reconstruction

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...

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Autores principales: Wei, Kai-Che, Yang, Kuo-Chung, Chen, Lee-Wei, Liu, Wen-Chung, Chen, Wen-Chieh, Chiou, Wen-Yen, Lai, Ping-Chin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5073289/
https://www.ncbi.nlm.nih.gov/pubmed/27767187
http://dx.doi.org/10.1038/srep35875
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author Wei, Kai-Che
Yang, Kuo-Chung
Chen, Lee-Wei
Liu, Wen-Chung
Chen, Wen-Chieh
Chiou, Wen-Yen
Lai, Ping-Chin
author_facet Wei, Kai-Che
Yang, Kuo-Chung
Chen, Lee-Wei
Liu, Wen-Chung
Chen, Wen-Chieh
Chiou, Wen-Yen
Lai, Ping-Chin
author_sort Wei, Kai-Che
collection PubMed
description 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.
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spelling pubmed-50732892016-10-26 Management of fluoroscopy-induced radiation ulcer: One-stage radical excision and immediate reconstruction Wei, Kai-Che Yang, Kuo-Chung Chen, Lee-Wei Liu, Wen-Chung Chen, Wen-Chieh Chiou, Wen-Yen Lai, Ping-Chin Sci Rep Article 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. Nature Publishing Group 2016-10-21 /pmc/articles/PMC5073289/ /pubmed/27767187 http://dx.doi.org/10.1038/srep35875 Text en Copyright © 2016, The Author(s) http://creativecommons.org/licenses/by/4.0/ This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/
spellingShingle Article
Wei, Kai-Che
Yang, Kuo-Chung
Chen, Lee-Wei
Liu, Wen-Chung
Chen, Wen-Chieh
Chiou, Wen-Yen
Lai, Ping-Chin
Management of fluoroscopy-induced radiation ulcer: One-stage radical excision and immediate reconstruction
title Management of fluoroscopy-induced radiation ulcer: One-stage radical excision and immediate reconstruction
title_full Management of fluoroscopy-induced radiation ulcer: One-stage radical excision and immediate reconstruction
title_fullStr Management of fluoroscopy-induced radiation ulcer: One-stage radical excision and immediate reconstruction
title_full_unstemmed Management of fluoroscopy-induced radiation ulcer: One-stage radical excision and immediate reconstruction
title_short Management of fluoroscopy-induced radiation ulcer: One-stage radical excision and immediate reconstruction
title_sort management of fluoroscopy-induced radiation ulcer: one-stage radical excision and immediate reconstruction
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5073289/
https://www.ncbi.nlm.nih.gov/pubmed/27767187
http://dx.doi.org/10.1038/srep35875
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