RESUMO
Brachytherapy delivered within the early post-operative period has been associated with delayed healing and wound breakdown. The objective of this study was to determine whether reconstruction with a microvascular free flap reduced the incidence of wound breakdown after early post-operative brachytherapy and wide excision of soft tissue sarcomas. Four patients with sarcomas underwent excision and free flap reconstruction. Brachytherapy was administered in the early post-operative period using Iridium-192 wires via tubes inserted intraoperatively. In three of the four patients the wounds healed uneventfully, demonstrating that brachytherapy can be delivered in the early post-operative period following free flap reconstruction without an increase in the frequency of wound breakdown. There has been no local recurrence to date in this group of patients.
Assuntos
Braquiterapia , Sarcoma/radioterapia , Sarcoma/cirurgia , Retalhos Cirúrgicos , Idoso , Idoso de 80 Anos ou mais , Braquiterapia/métodos , Feminino , Antebraço , Humanos , Radioisótopos de Irídio , Perna (Membro) , Leiomiossarcoma/radioterapia , Leiomiossarcoma/cirurgia , Lipossarcoma/radioterapia , Lipossarcoma/cirurgia , Pessoa de Meia-Idade , Dosagem Radioterapêutica , Sarcoma/fisiopatologia , Fatores de Tempo , Resultado do Tratamento , CicatrizaçãoRESUMO
A prospective controlled trial was carried out to assess the healing efficacy of calcium alginate and paraffin gauze on split skin graft donor sites. Thirty patients were randomised to the calcium alginate group and 21 to the paraffin gauze group. The donor sites were assessed at 10 days post harvesting to determine if they were completely healed (100%) or not. Twenty one of the 30 patients dressed with calcium alginate were completely healed at day 10, while only 7/21 in the paraffin gauze group were healed (p < 0.05). There were two infections in the study, both occurring in the alginate group while there was no difference in dressing slippage between the two groups. Calcium alginate dressings provide a significant improvement in healing split skin graft donor sites.
Assuntos
Alginatos/uso terapêutico , Bandagens , Transplante de Pele , Cicatrização/efeitos dos fármacos , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Coloides/uso terapêutico , Feminino , Ácido Glucurônico , Ácidos Hexurônicos , Humanos , Masculino , Curativos Oclusivos , Vaselina , Estudos ProspectivosRESUMO
Brachytherapy delivered within the early postoperative period has been associated with delayed wound healing and wound breakdown. The objective of this study was to determine whether reconstruction with a microvascular free flap reduced the incidence of wound breakdown in the presence of early postoperative brachytherapy following wide excision of soft tissue sarcomas and head and neck carcinomas. Ten patients with malignant tumours underwent wide excision and free flap reconstruction. Brachytherapy was administered using Iridium-192 wires in the early postoperative period via tubes inserted intra-operatively. In 9 of the 10 patients the wounds healed uneventfully, demonstrating that brachytherapy can be delivered in the early postoperative period following free flap reconstruction without an increase in the frequency of wound breakdown.