Successful Management of Radiation Injury of Soft Tissue-A Case Report and Literature Review

軟組織放射線傷害傷口之處理病例報告及文獻回顧

楊士弘(Shih-Hung Yang) ； 戴浩志(Hao-Chih Tai) ； 陳明庭(Ming-Ting Chen)

《中華民國重建整形外科醫學會雜誌》 5卷3期 (1996/09) Pp. 195-201

https://doi.org/10.7096/JPRSA.199609.0011

摘要

一位61歲女性病人因罹患鼻咽癌而接受頭頸部放射線治療，三個月後發生右頸部巨大壞死性潰瘍。於潰瘍傷口中，見到舌骨、甲狀腺軟骨及結紮後的右總頸動脈，以及見到食道瘻管。住院後施予甲狀腺賀爾蒙補充、營養補充，以及靜脈抗生素注射，並對局部傷口給予清創術、親水性膠質敷料包紮，以及高壓氧治療。在傷口的肉芽組織形成後，以胸大肌肌皮瓣的皮膚覆蓋食道瘻管及以胸大肌覆蓋右頸巨大潰瘍，並以裂層皮膚覆蓋於胸大肌上。術後潰瘍傷口順利癒合。病人於右頸傷癒後，左頸部又發生表皮乾性脫屑傷口，於清創、親水性膠質敷料包紮及高壓氧治療後，施以裂層皮膚移植，傷口亦順利癒合。

並列摘要

A 61 year-old female presented with a large post-radiotherapy ulcer over the right neck and exposure of hyoid bone, thyroid cartilage and ligated right common carotid artery. An esophageocutaneous fistula with saliva drooling was noted in the ulcer. There was dry desquamation with eschar occurred over the irradiated skin of the left neck during the same admission. After the wound managements including local wound debridement, hydrocolloid dressing, and hyperbaric oxygen therapy, the wound condition improved rapidly with nice granulation bed at the bottom. The pectoralis major musculocutaneous flap was utilized to patch up the esophageal fistula and fill up the huge ulcer of the neck then split thickness skin graft was done over the pectoralis major muscle flap for outside skin coverage. Later ulcer of the other side of the neck was also treated with hydrocolloid dressing, hyperbaric oxygen and split thickness skin graft. She had satisfactory course of treatment and discharged with ambulatory status.

並列關鍵字

radiation-injured soft tissue ； hydrocolloid dressing ； hyperbaric oxygen therapy ； pectoralis major musculocutaneous flap