Use of fat transfer to treat a chronic, non-healing, post-radiation ulcer: a case study
Use of fat transfer to treat a chronic, non-healing, post-radiation ulcer: a case study
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DOI：
10.12968/jowc.2017.26.5.272
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发表时间：
2017-05-01
影响因子：
1.9
通讯作者：
Singh, S.
中科院分区：
文献类型：
--
作者：
Mohan, A.;Singh, S.
目的：放射损伤组织中的伤口愈合问题和溃疡是外科手术的挑战。临床研究表明，在受辐射区域移植脂肪组织可以改善皮肤质量并具有再生作用。本案例研究描述了脂肪移植如何促进对其他治疗方法无效的慢性溃疡的愈合。 病史：一位 67 岁的女士腿部患有慢性、不愈合的溃疡，她切除了鳞状细胞癌，随后进行了放射治疗。尽管进行了多次切除，溃疡仍继续引起症状。在最初的手术中，脂肪渗透到溃疡周围和溃疡下方，随后患者接受了广泛的局部切除和分层皮肤移植。组织学显示有放射后皮炎溃疡，没有恶性肿瘤的证据。经过一段时间的敷料治疗后，溃疡面积有所缩小，病变周围有更多的脂肪浸润。两个月后，溃疡已完全愈合，且未复发。结论：利用脂肪干细胞来治愈受辐射组织的伤口，一段时间以来一直是研究的焦点。这个案例凸显了脂肪组织改善受损皮肤的潜力。它的使用可以消除复杂外科手术的需要。
Objective: Problematic wound healing and ulceration in radiation-damaged tissue is a surgical challenge. Clinical studies have shown that grafting fat tissue in an irradiated area can improve the quality of the skin and has regenerative effects. This case study describes how fat transfer led to the healing of a chronic ulcer resistant to other forms of treatment.Case history: A 67-year-old lady with a chronic, non-healing ulcer in her leg had a squamous cell carcinoma excised, followed by radiotherapy. Despite multiple excisions, the ulcer continued to cause symptoms. Following an initial procedure in which fat was infiltrated around and under the ulcer, the patient underwent a wide local excision and split-thickness skin grafting. Histology demonstrated a post-radiation dermatitis ulcer with no evidence of malignancy. After a period of management with dressings showing a reduction in ulcer size, more fat was infiltrated around the lesion. Two months later, the ulcer had fully healed and has not recurred.Conclusion: The use of adipose-derived stem cells to heal wounds in irradiated tissue has been the focus of research for some time. This case highlights the potential of adipose tissue to improve damaged skin. Its use could negate the need for complex surgical procedures.