ABSTRACT
Radiation-induced skin injury has been reported for multiple fluoroscopic procedures. Previous studies have indicated that prolonged fluoroscopic exposure during even a single percutaneous coronary intervention (PCI) may lead to cutaneous radiation injury. We document a novel case of deep muscle damage requiring wide local debridement and muscle flap reconstruction in a 59-year-old man with a large radiation-induced wound to the lower thoracic region following 1 prolonged PCI procedure. The deep muscular iatrogenic injury described in this report may be the source of significant morbidity. Recommendations to reduce radiation-induced damage include careful examination of the skin site before each procedure, minimized fluoroscopy time, utilization of pulse fluoroscopy, employment of radiation filters, and collimator s and rotation of the location of the image intensifier.
Subject(s)
Angioplasty, Balloon, Coronary/adverse effects , Iatrogenic Disease , Muscles/radiation effects , Radiation Injuries/etiology , Skin/radiation effects , Coronary Stenosis/complications , Coronary Stenosis/therapy , Fluoroscopy/adverse effects , Humans , Male , Middle Aged , Postoperative Complications/etiology , Skin Ulcer/etiologyABSTRACT
The ability to heal an injury is a biologic necessity for all organisms, with mammals lagging in proficiency when compared with lower life forms that have the ability to regenerate differentiated structures. Technology and increased scientific knowledge have established a coordinated interplay that has improved the ability to manage wounds in a logical manner, and, on occasion, to accelerate the healing process. Insight into the complex chain of events leading to the formation of scar is a necessity for every individual who attempts wound management.