Management of Radiation-induced Tissue Injuries: A Review of Current Treatment Strategies

Simman, Richard; Bach, Karen; Abbas, Fuad; Klomparens, Kara; Brickman, Bradley

doi:10.1097/gox.0000000000005043

Cited by 2 publications

(1 citation statement)

References 56 publications

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“…Skin and soft tissue changes have been reported in approximately 85-95% of patients undergoing radiation therapy ( 20 ). Radiation effects can be categorized as early (days to weeks) or delayed (several months to years) and can present with microvascular damage, tissue fibrosis, and ulcers ( 4 ).…”

Section: Discussionmentioning

confidence: 99%

Management of irradiated post-mastectomy wound dehiscence with synthetic electrospun fiber matrix: a case report

Montminy,

Oppenheimer,

Cocco

2024

Front. Oncol.

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Breast-conserving surgery (BCS) is a well-established standard treatment option alternative to mastectomy for patients with early breast cancer that consists of a lumpectomy followed by adjuvant radiotherapy. However, irradiated tissues are at an increased risk of wound healing complications when post-treatment surgical management is required. The management of an irradiated wound dehiscence can be challenging, as it often requires a multimodal treatment approach that includes more invasive interventions when compared to a traditional surgical wound dehiscence. We present a 64 year old female patient with a remote history of right BCS with radiation therapy for early breast cancer 12 years ago, who recently required a simple mastectomy due to ipsilateral breast cancer recurrence. The post-operative course was complicated by dehiscence of the mastectomy wound. After standard wound care therapies failed, her surgical wound successfully healed after treatment with a synthetic electrospun fiber matrix application. Patients with additional comorbidities often do not qualify for invasive reconstructive options; therefore, effective local management options are warranted. This is the first reported case documenting synthetic electrospun fiber matrix efficacy and safety in healing a dehisced surgical wound within a previously irradiated fibrotic area, without the need for further invasive surgical intervention. Larger scale research, such as a prospective cohort study or randomized control trial, is needed to investigate its novel use in irradiated wounds.

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Section: Discussionmentioning

confidence: 99%

Management of irradiated post-mastectomy wound dehiscence with synthetic electrospun fiber matrix: a case report

Montminy,

Oppenheimer,

Cocco

2024

Front. Oncol.

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Bilaminar dermal regeneration template for the coverage of exposed dura in a patient irradiated for tinea capitis

Stojičić,

Jurišić,

Nikolić-Živanović

et al. 2024

Medicinska istraživanja

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Introduction: Before the discovery of antimycotics powerful enough to penetrate the hair follicle, the use of X ray radiation was a worldwide accepted method for scalp epilation as part of the treatment for tinea capitis in children. More than five decades later, the consequences of radiation in ringworm therapy became evident and included high rates of recurrent and aggressive forms of non-melanoma skin tumors, brain tumors and meningiomas, as well as osteoradionecrosis. Scalp reconstruction presents a challenge due to the unique anatomic characteristics of the scalp as well as tissue inelasticity. Cases of bilaminar dermal regeneration templates applied directly on dura in the literature are seldom described. Case report: A male patient irradiated due to tinea capitis as a child, presented at our institution for the management of multiple recurrent infiltrative basocellular carcinomas (BCC) and osteoradionecrosis of the scalp. Severe skin atrophy affected all areas of the scalp except for the forehead, which showed moderate atrophy. The patient had multiple surgeries over the next few years due to the emergence of new and recurrent BCCs as well as zones of osteoradionecrosis of the scalp. Post-surgical defects were commonly reconstructed using local fasciocutaneous flaps and skin autografts. Surgical site complications, including partial flap necrosis or autograft loss, frequently followed the procedures. After exhausting all reconstructive options by repeated previous surgeries, a post-surgical defect following ostectomy of newly developed ORN in the occipital region was reconstructed using a dermal substitute applied directly on the dura and covered with a skin autograft, in a two-step procedure. Due to a high perioperative risk for general anesthesia, the intervention was performed under local anesthesia with anesthesiologic monitoring. The postoperative period was uneventful and the skin autograft had a 100% take. Conclusion: The use of bilaminar dermal regeneration template Integra® can be efficiently utilized for the reconstruction of full thickness skin and calvaria defects in complex cases when all other reconstructive methods are exhausted.

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Management of Radiation-induced Tissue Injuries: A Review of Current Treatment Strategies

Cited by 2 publications

References 56 publications

Management of irradiated post-mastectomy wound dehiscence with synthetic electrospun fiber matrix: a case report

Management of irradiated post-mastectomy wound dehiscence with synthetic electrospun fiber matrix: a case report

Bilaminar dermal regeneration template for the coverage of exposed dura in a patient irradiated for tinea capitis

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