The repair of acute radiation skin injury from (192) Ir source at ”5.7” radiation accident in Nanjing

Abstract

Objective To explore the application of free latissimus dorsi myocutaneous flap to repair of degree Ⅳ acute radiation skin injury. Methods Review and summary were made of the repair process of degree Ⅳ acute radiation skin injury on right thigh of a patient namedWang. Necrotic tissues was excised 62 d after radiation exposure. The extended wounds were covered 171 d after exposure with free joint latissimus dorsi myocutaneous flap (on the right latissimus dorsi myocutaneous flap and shoulder flap joint). The flap necrosis due to vascular anastomosis thrombosis was noted in part 180 days after exposure, and necrotic tissues was covered again 263 days after exposure with free latissimus dorsi myocutaneous flap on the left side. Results Degree Ⅳ acute radiation wound on the right thigh had already healed completely with ideal appearance gained, and functionality restored to large extent. Finally, the patient could walk about with the aid of crutch a year after exposure. Conclusions Latissimus dorsi muscle flap has constant vascular anatomy and multi-organizational capacity, and can provide larger area of skin grafts. Both free latissimus dorsi myocutaneous flap and its derived joint myocutaneous flap are applicable for repairing large area of degree Ⅳ acute radiation injury. Also, function and appearance can be achievable, which is worthy of extended uses. Key words: 192Ir; Mild bone marrow form of acute radiation sickness from external exposure; Degree Ⅳ acute radiation skin injury; Repair; Free latissimus dorsi myocutaneous flap