Reconstruction of a Forearm Radiation Ulcer Using an Anterolateral Thigh Flap: A Case Report

We present a rare case of a forearm radiation ulcer. Recently, technological advances in intravascular treatments involving X-ray radiography have enabled the application of this treatment in more patients. This has caused more frequent problems due to radiation ulcers. Here we report the case of a 54-year-old man who developed an ulcer on his left forearm six months after placing a stent graft to treat an abdominal aortic aneurysm. A radiation ulcer was diagnosed because of the distance between the position of the ulcer and pigment deposition in the lateral abdominal region and because of the following pathological findings: coagulative necrosis and fibrinoid degeneration and narrowing of the lumen in the small blood vessels. The ulcer was treated by debridement (skin defect size, 22 × 10 cm), followed by reconstruction with an anterolateral thigh flap (23 × 12 cm). Cosmetic and functional improvements were observed, with the latter indicated by an increased range of motion. Levels of evidence: V.