Soft Tissue Radionecrosis

 

 
   Hospital Comprehensive Wound
   Healing Center which was
   affiliated with Praxis Clinical
   Services.

 

Soft Tissue
Radionecrosis
Center for Wound Healing
and Hyperbaric Medicine
240 Williamson Street, Suite 104 - Elizabeth, NJ 07207
(908) 994-5480
PATIENT:
48 y.o. male, history of wound on left shoulder x 20 years.
WOUND HISTORY:
12/99 Physician examination described "a huge, foul-smelling, necrotic, invasive tumor that measures 17cm x 17cm x 5cm." Patient refused surgical intervention.
1/00 Radiation begun, continued through mid-April total dose 7020cGy. Dressings were saline gauze and hydrogen peroxide gauze.
4/11/00 CT of shoulder reveals ulcerating mass of left shoulder, no evidence of adenopathy.
6/16/00 Resection of shoulder area, involving clavicle, surrounding muscles to brachial plexis with resultant large soft tissue defect treated with wet-to-damp saline dressings.
6/28/00
Regional flap rotatation and STSG closure.
7/9/00 Discharged home with small separation between graft and neck, instructed to continue saline gauze dressings.
CLINICAL CHALLENGE:
Long-standing, neglected defect, post-surgical and radiation intervention in a
non-compliant subject with ETOH abuse, 1-1 1/2 ppd smoker
RESULTS:
HBO2 discontinued after 39 treatments. No further skin grafting needed.

Referral Information

Patients should be referred to the Center for Wound Healing and Hyperbaric Medicine at Trinitas Regional Medical Center for aggressive, outcome based wound management. Our center is designed to compliment the attending physicianís services by providing expert wound management consultation and care including the application of advanced wound care technology and hyperbaric oxygen treatment as indicated based on a comprehensive system of evidence based clinical practice guidelines. The referring physician will continue to treat comorbid conditions and provide for the patientís overall medical care. Hyperbaric oxygen treatment is available specifically for the treatment of soft tissue radionecrosis, osteoradionecrosis, osteomyelitis, clostridial myonecrosis and other necrotizing soft tissue infections, compromised skin grafts and flaps, crush injuries and other acute traumatic ischemias, and diabetic wounds of the lower extremities. All etiologies of wound healing failure are accepted for evaluation and care.

Types of wounds treated include Diabetic, Venous Stasis, Ischemic, Pressure, Traumatic, Surgical and other wounds that resist healing.
Problem wound patients should be referred to the Center when:
The wound has failed to show significant progress in 4 weeks of standard care
When the wound involves deep tissue structures or is limb or life threatening
When the wound is complicated by significant comorbidities including peripheral
    vascular disease, persistent edema, persistent infection, prior radiation treatment
   to the area, or compromised immune status of the patient

To refer a patient, please call (908) 994-5480 or visit us at www.trinitashospital.com


 

 

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