J Korean Med Assoc.  2015 Sep;58(9):801-808. 10.5124/jkma.2015.58.9.801.

Radiation ulcers and other chronic wounds

• Hwang NH
• Chung JH
• Kim DW

• KMID: 2195092
• DOI: http://doi.org/10.5124/jkma.2015.58.9.801

Abstract

Radiation ulcers are wounds caused by acute or chronic effects of ionizing radiation. The injury may involve the skin, underlying soft tissue, and even deeper into bones. Radiation is used alone or in combination with surgery and chemotherapy. Although it is useful to affect tumor death, it also exerts a deleterious effect on surrounding normal tissues. These effects are either acute or can manifest months or years after the treatment. The chronic wounds are a result of impaired wound healing. This impairment leads to fibrosis, nonhealing ulcers, lymphedema and radionecrosis amongst others.

Keyword

Radiotherapy; Radiation; Radiation damage; Wounds and injuries

MeSH Terms

Drug Therapy
Fibrosis
Lymphedema
Radiation, Ionizing
Radiotherapy
Skin
Ulcer*
Wound Healing
Wounds and Injuries*

Figure

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  Figure 1 Grade 3 dermatitis with confluent desquamation.

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  Figure 2 Nonhealing chest wound in a patient who had a mastectomy followed by radiotherapy.

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  Figure 3 Transverse rectus abdominis myocutaneous free flap was used to cover the defect. (A) The defect was radically debrided before flap coverage, (B) 7 weeks after coverage.

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  Figure 4 Post-radiation lymphedema on the left lower extremity in a 62-year-old female patient.

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  Figure 5 Venous ulcer, in a 68-year-old male patient.

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  Figure 6 Both lower extremity (A) medial tibia and (B) ankle ulcers, in a patient with systemic lupus erythematous.

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  Figure 7 A 10-cm ulcer on the left calf showing devitalized tissue and necrotic muscle in a 47-year-old female patient diagnosed with Behcet's disease.

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  Figure 8 (A) After debridement and cyclosporine therapy, the healthy granulation tissue and marginal epithelial growth was seen. (B) Split-thickness skin was grafted from the scalp. (C) Postoperative 2 weeks, showing complete epithelialization.

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