Dermal Grafts to Bony Defects in Irradiated and Nonirradiated Tissues

Lambert, Paul M.; Patel, Mahendrakumar; Gutman, E; Campana, Hernan A.

doi:10.1001/archotol.1984.00800360029006

Cited by 7 publications

(3 citation statements)

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“…Clinical sequelae include skin atrophy, soft tissue fibrosis, desquamation, epithelial ulceration, fistula formation and major vessel rupture [1,2]. Impaired peri- and postoperative wound healing and the complications associated with it can be observed [3,4] frequently and may require extensive reconstructive efforts [5-7] (Figure 1). …”

Section: Introductionmentioning

confidence: 99%

Wound healing after radiation therapy: Review of the literature

et al. 2012

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Radiation therapy is an established modality in the treatment of head and neck cancer patients. Compromised wound healing in irradiated tissues is a common and challenging clinical problem. The pathophysiology and underlying cellular mechanisms including the complex interaction of cytokines and growth factors are still not understood completely. In this review, the current state of research regarding the pathomechanisms of compromised wound healing in irradiated tissues is presented. Current and possible future treatment strategies are critically reviewed.

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Section: Introductionmentioning

confidence: 99%

Wound healing after radiation therapy: Review of the literature

et al. 2012

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“…Extensive efforts including microvascular free flap surgery may be required to manage these complications [12,15,16]. An important contributor to the pathomechanism of this frequent complication is endothelial dysfunction, which manifests in atherosclerosis, fibrosis and vascular occlusion [7,17].…”

Section: Introductionmentioning

confidence: 99%

Effects of radiation on the expression of adhesion molecules and cytokines in a static model of human dermal microvascular endothelial cells

Haubner

Ohmann

Pohl

et al. 2013

Clinical Hemorheology and Microcirculation

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BACKGROUND: Radiation-induced wound healing complications represent an important clinical problem. Microvascular compromise is an important component of its pathogenesis and the microvascular endothelial cell is the key representative affected at the cellular level. MATERIAL AND METHODS: Human dermal microvascular endothelial cells (HDMEC) were cultured and irradiated with doses of 2 to 12 Gy. Cell density was determined 48 h after radiation using a semi-automated cell counting system. Levels of interleukin-6 (IL-6), basic fibroblast growth factor (FGF), intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) in the supernatants of HDMEC were determined by polymerase chain reaction (PCR) and enzyme-linked immunosorbent assay (ELISA). Non irradiated HDMEC were used as controls. RESULTS: Cell density was significantly impaired in irradiated cells compared to non irradiated controls. Radiation resulted in significant elevation of levels of IL-6, FGF, ICAM-1 and VCAM-1 in the supernatants of HDMEC in a dose dependent manner. CONCLUSION: The inflammatory response observed clinically after radiation seems to correlate with elevated expression of cytokines and adhesion molecules by microvascula endothelial cells. The model of HDMEC documents the impairment of microcirculation. These in vitro changes may enhance our understanding of the pathomechanisms leading to radiation-induced vasculitis and associated wound healing problems.

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“…Radiation therapy also plays a hand in choosing the optimal closure technique. As suggested by Lambert and Patel, placement of skin grafts on irradiated tissue has a high failure rate compared with similar grafts placed on a nonirradiated bed 10. This may lead to the placement of a free tissue graft, which in a nonirradiated patient would not be required 2.…”

Section: Discussionmentioning

confidence: 99%