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Case Series/Study
Surgery, radiation and chemotherapy constitute well established modalities in the treatment of cancer. Radiotherapy is useful in reducing the tumor burden, but exerts deleterious effects to the surrounding tissues. Skin ulcers, fibrosis, lymphedema and osteoradionecrosis are some of the manifestations. Wound healing is often affected, making the cure of skin wounds a real challenge.
Methods:
The electronic medical records of Stony Brook Southampton Hospital Wound Care Center were reviewed and identified 15 patients that presented with post-radiation wounds. All of them established care with us, but the majority was not able to complete the treatment due to their comorbidities. Here, we present the case of two patients with radiation induced wounds that achieved complete healing, after a prolonged and complicated course of treatment.
Results:
Two male patients, of 87 and 75 years old age, presented to our wound care center with left lower extremity post-radiation wound. Maximum size was 22.2 cm2 and 10.5cm2 respectively. The two patients underwent treatment with weekly appointments, which included close monitoring, serial debridements and advanced skin products. Collagen dressings (21 and 6 applications respectively), were followed by amnion/chorion membrane placental allografts (15 and 5 products respectively). Unna boot was applied for compression therapy. None of the patients was cleared by their oncologist to undergo hyperbaric oxygen therapy. Total treatment duration was 693 and 479 days, with complete healing being achieved. No recurrence has been noticed.
Discussion:
Application of collagen dressing with antimicrobial barrier followed by amnion/chorion membrane placental allografts seems to be a safe technique with promising results in the treatment of radiation induced wounds. Future studies should focus on understanding the mechanism behind these wounds, and the difference between different modalities.
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