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二氧化碳激光治疗作为放射治疗后手术伤口不愈合的一种选择——一项回顾性研究

Co LASER Therapy as an Option for Non-Healing Surgical Wounds after Radiation Therapy-A Retrospective Study.

作者信息

Patil Basavaraj R, Shikha Nirdhum

机构信息

Department of Head and Neck Surgical Oncology, The Karnatak Cancer Therapy and Research Institute, Hubli, Karnataka India.

出版信息

J Maxillofac Oral Surg. 2024 Aug;23(4):953-958. doi: 10.1007/s12663-024-02144-1. Epub 2024 Mar 19.

Abstract

BACKGROUND

Radiation has a huge impact on wound healing with progressive and irreversible impairment at the cellular level, making it very challenging for surgeons in terms of wound healing after salvage surgery in previously radiated patients. CO LASER helps in wound healing by its combined effect yielding a better result. Our study aims to retrospectively evaluate the healing outcome in a series of patients post-radiation, diagnosed with head and neck neoplasm recurrence, undergoing CO LASER treatment for non-healing surgical wounds, post salvage surgery having a previous history of radiotherapy in Head and Neck cancers.

METHODOLOGY

A total of seven patients from January 2018 to June 2021 who underwent CO LASER treatment in non-healing surgical wounds, post salvage surgery having a previous history of radiotherapy in Head and Neck cancers were included in this study. Clinical assessment of healing in terms of complete healing, the appearance of the scar, and patient satisfaction, with a follow-up for 18 months.

RESULTS

This series included a total of seven patients, five men and two women, aged between 27 and 62 years with a mean age of 47 years. Three patients had a previous history of radiation, and four patients had a previous history of chemoradiation (CT + RT). Successful healing was noted in all the seven patients. Post-healing all patient's scars were soft, flat, and clinically acceptable. One patient presented with hypopigmentation.

CONCLUSION

CO LASER therapy speeds up the healing process with minimal discomfort to the patient. CO LASER therapy can be used as an alternative for non-healing surgical wounds after salvage surgery in previously radiated  patients with an unhealthy wound bed where split-thickness skin graft uptake is unpredictable.

摘要

背景

辐射对伤口愈合有巨大影响,在细胞水平上造成渐进性和不可逆的损伤,这使得对于曾接受过放疗的患者进行挽救性手术后的伤口愈合,对外科医生而言极具挑战性。二氧化碳激光通过其综合作用有助于伤口愈合,能产生更好的效果。我们的研究旨在回顾性评估一系列曾接受放疗、被诊断为头颈部肿瘤复发、在挽救性手术后因手术伤口不愈合而接受二氧化碳激光治疗且既往有头颈部癌症放疗史的患者的愈合结果。

方法

本研究纳入了2018年1月至2021年6月期间共7例在挽救性手术后因手术伤口不愈合而接受二氧化碳激光治疗且既往有头颈部癌症放疗史的患者。从完全愈合情况、瘢痕外观和患者满意度方面对愈合情况进行临床评估,并进行18个月的随访。

结果

该系列共包括7例患者,5例男性和2例女性,年龄在27至62岁之间,平均年龄47岁。3例患者有放疗史,4例患者有放化疗史(CT + RT)。所有7例患者均实现了成功愈合。愈合后所有患者的瘢痕均柔软、平坦,临床效果可接受。1例患者出现色素减退。

结论

二氧化碳激光治疗可加快愈合过程,对患者造成的不适最小。对于曾接受放疗、伤口床不健康且断层皮片移植吸收情况不可预测的患者,在挽救性手术后,二氧化碳激光治疗可作为手术伤口不愈合的一种替代治疗方法。

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