Surgery in the treatment of sequelae in the soft tissues from radiotherapy

A series of 151 patients treated surgically for sequelae from radiotherapy of the soft tissues is reported. In 90 cases the resection or destructive surgery was completed by plastic surgery. Satisfactory results were obtained in all 101 cases of somatic sequelae. Clinical cure was obtained after three years in two-thirds of 41 cases in which the somatic sequelae were associated with neoplastic recurrence and in 7 of the 9 cases of radioinduced neoplasms. Postoperative complications were most frequently septic and included fistulas, diastasis, and necrosis of the flap. It is inferred that: 1) to prevent the risk of diastasis, it is advisable to avoid as much as possible tension on the irradiated tissues in the attempt to bring together the margins of the surgical wound; 2) plastic reconstructive surgery allows wide resection in order to reach nondystrophic tissues, to remove latent sepsis and to prevent neoplastic recurrence; 3) an interval, of even more than one month, between the resection and the plastic surgery is often advisable.