Exposure to an iridium-192 source in an industrial safety worker

Radiation burn injuries account for 0.2% of burn injury admissions. Treatment of radiation burns remains challenging because of unpredictable inflammatory changes and soft tissue necrosis. Conventional treatment consists of multistaged surgical procedures. Here, we present a case of an Iridium-192 exposure treated nonoperatively. A 23-year-old man presented with a 7-day-old, less than 1% TBSA radiation burn to his right hand. He initially sought treatment at an outside hospital and plastic surgeon's office postinjury days 2 and 3. He later presented to our facility because of worsening pain, edema, and discoloration. He was admitted and hospitalized for 15 days. Narcotics were initiated and wound care consisted of daily antibiotic ointment and petroleum gauze dressings. We continued dexamethasone and pentoxyfilline for 1 week. He underwent nineteen 90-minute treatments of hyperbaric oxygen therapy during an 8-week period. He had complete wound healing 1 month postdischarge. This case report provides background on radiation burn injuries and applicability of nonoperative management in treating radiation burn injuries. Furthermore, it encourages the development of individualized treatment plans, consideration of the use of hyperbaric oxygen therapy, referral to a burn center, and consulting radiation experts for guidance.