NIKPOUR H. PEDICLE MUSCLE FLAPS IN IRRADIATED WOUNDS: DOES PREVIOUS RADIATION OF THE MUSCLE TO BE TRANSPOSED-AFFECT THE OUTCOME? A 9 YEARS EXPERIENCE OVER 206 CONSECUTIVE CASES. Med J Islam Repub Iran 2002; 15 (4) :189-193
URL:
http://mjiri.iums.ac.ir/article-1-781-en.html
From the Department of Plastic and Reconstructive Surgery, Shiraz University of Medical Sciences, Shiraz, I.R. Iran.
Abstract: (4400 Views)
Radiation-related wounds challenge surgeons in all disciplines of surgery.
Wound-healing complications are commonplace, and solutions for reconstruction
are limited. Muscle and musculocutaneous flaps have improved this situation.
But the question is, does previous radiation of the muscle to be transposed
affect the outcome?
143 consecutive previously irradiated patients treated with muscle or musculocutaneous
flaps composed the group under consideration: these 143 patients
had 206 muscles transposed. The overall complication rate for muscle transposition
to close a radiated wound was 20 percent.
Of the 143 patients who received radiation, 62 patients had the muscle transposed
for wound closure from the primary field of radiation. 81 patients were
closed with non-irradiated muscle. When the transposed muscle had been radiated,
the complication rate was 29.6 percent in 14.3 percent, the entire muscle
underwent necrosis, requiring total removal and a second tissue transposition from
a non-irradiated source to achieve closure. The subgroup using non-irradiated
muscle had a complication rate of 12.2 percent 1 patient in this group had complete
flap necrosis requiring a second tissue transposition. No postoperative deaths
were encountered.
The experience in our department reveals that non-irradiated muscle is the
best choice for closure of a radiated wound, if possible.