Rudolph R
Plast Reconstr Surg. 1982 Aug;70(2):179-85. doi: 10.1097/00006534-198208000-00009.
Complications of modern surgery for radiotherapy skin damage reviewed in 28 patients who had 42 operations. Thin split-thickness skin grafts for ulcer treatment had a 100 percent complication rate, defined as the need for further surgery. Local flaps, whether delayed or not, also had a high rate of complications. Myocutaneous flaps for ulcers had a 43 percent complication rate, with viable flaps lifting off radiated wound beds. Only myocutaneous flaps for breast reconstruction and omental flaps with skin grafts and Marlex mesh had no complications. The deeper tissue penetration of modern radiotherapy techniques may make skin grafts and flaps less useful. In reconstruction of radiation ulcers, omental flaps and myocutaneous flaps are especially useful, particularly if the radiation damage can be fully excised. The pull of gravity appears detrimental to myocutaneous flap healing and, if possible, should be avoided by flap design.
对28例患者进行的42次手术回顾了现代手术治疗放疗性皮肤损伤的并发症。用于溃疡治疗的薄断层皮片移植的并发症发生率为100%，定义为需要进一步手术。局部皮瓣，无论是否延迟，并发症发生率也很高。用于溃疡的肌皮瓣并发症发生率为43%，有活力的皮瓣从受辐射的伤口床掀起。只有用于乳房重建的肌皮瓣以及带皮片和Marlex网的大网膜瓣没有并发症。现代放疗技术更深的组织穿透性可能使皮片移植和皮瓣的用处减小。在放射性溃疡的重建中，大网膜瓣和肌皮瓣特别有用，尤其是在放射损伤能够完全切除的情况下。重力作用似乎不利于肌皮瓣愈合，如有可能，应通过皮瓣设计避免。
