Otterburn David, Losken Albert
Emory Division of Plastic and Reconstructive Surgery, Atlanta, GA 30308, USA.
Ann Plast Surg. 2010 Nov;65(5):462-5. doi: 10.1097/SAP.0b013e3181d6e2d3.
Iatrogenic radiation injuries are an accepted complication of therapeutic radiation therapy, however, they can also occur during fluoroscopic procedures. These are challenging wounds and are often misdiagnosed, leading to frustration for the patient and treating physicians. We reviewed 3 cases of severe fluoroscopic burns with ulceration, non healing wounds, and preoperative debilitating pain. The average number of fluoroscopy procedures was 2.7, with an average total fluoroscopy procedure time of 10 hours. The skin changes presented at 2.3 weeks with the time to surgical intervention being on average 19 months. All patients had immediate resolution of their preoperative pain and a stable healed wound at follow-up. Fluoroscopic radiation burns can be adequately treated with wide excision of all affected tissue and vascularized flap coverage.
医源性辐射损伤是放射治疗公认的并发症,然而,它们也可能在荧光镜检查过程中发生。这些是具有挑战性的伤口,常常被误诊,给患者和治疗医生带来困扰。我们回顾了3例严重的荧光镜烧伤病例,这些病例伴有溃疡、伤口不愈合以及术前使人衰弱的疼痛。荧光镜检查的平均次数为2.7次,荧光镜检查的总平均时间为10小时。皮肤变化在2.3周时出现,至手术干预的平均时间为19个月。所有患者术前疼痛均立即缓解,随访时伤口愈合稳定。荧光镜辐射烧伤可通过广泛切除所有受影响组织并采用带血管蒂皮瓣覆盖进行充分治疗。