Addressing challenges in treating fluoroscopy-associated dermatitis: a case series.

Area of Science:

• Plastic Surgery
• Dermatology
• Radiology

Background:

• Fluoroscopy use is increasing, leading to more radiation-induced skin injuries.
• Radiation ulcers (grade 4 radiodermatitis) cause severe pain and disfigurement.
• Effective management strategies for these complex wounds are crucial.

Purpose of the Study:

• To address the challenges in managing fluoroscopy-associated radiodermatitis wounds.
• To present a surgical approach for treating radiation ulcers.
• To evaluate pain reduction and wound healing post-treatment.

Main Methods:

• A prospective case series of three patients with grade 4 radiodermatitis from fluoroscopy.
• Surgical treatment included debridement, wound bed preparation, and reconstruction with local/regional flaps (bilobed, V-Y, latissimus dorsi).
• Pain was assessed using a Visual Analogue Scale pre- and post-surgery (6 months).

Main Results:

• All three patients experienced significant pain improvement at six months post-surgery.
• Wound reconstruction was successful using various flap techniques.
• No wound recurrence was observed during a mean follow-up of 10 months.

Conclusions:

• Management of fluoroscopy-induced radiodermatitis is complex, requiring specialized surgical intervention.
• Plastic surgeons are vital in treating radiation ulcers through debridement and flap reconstruction.
• Surgical treatment offers significant pain relief and should be considered for radiation ulcers.