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

Abstract

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.