Đánh giá kết quả phẫu thuật tạo hình điều trị tổn thương da mạn tính do xạ trị tại Viện Bỏng Quốc gia

Abstract

Objective: To assess the surgical reconstruction results of skin radiation injuries in 30 patients who underwent radiotherapy. Subject and method: A cross-sectional study was conducted on 30 patients with skin ulcer caused by radiation after their treatment at National Institue of Burns Le Huu Trac from 10/2013 to 2/2017. Result: 30 patients, 5 were males and 25 were females. The mean age was 50.87 ± 17.67. 15 patients had a radiation injury of the chest wall, 9 patients suffered from head and neck’s lesion. The size of the soft tissue defects varied from 4 - 300cm² (mean 85.3 ± 68.9cm²). We used 6 local flaps, 19 pedicle flaps and 5 free flaps. The latissimus dorsi musculocutaneous flap and Gluteal perforator artery fasciocutaneous flap used in the majority of these cases. The surgical times averaged 136 minutes, drainage times averaged 10.4 ± 6 days. Hospitalization averaged 51 days and 12 hours. 18 patients had primary closure of the donor site, 12 patients required skin graft. One patient had partial flap necrosis, two instances had complete flap loss. Conclusion: The most reliable method to treat a radiation ulcer is wide excision of the affected tissue, followed by coverage with well-vascularized tissue. However, the treatment of chronic skin ulcers after radiotherapy has always been a big challenge for surgeons because of high incidence complications, increased risk infection, delayed wound and necrosis