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The Hazards of Surgery in Irradiated Tissue

The Hazards of Surgery in Irradiated Tissue Abstract Tissues subjected to irradiation undergo structural and physiologic changes often inexorably progressive. Surgical procedures may be performed in such tissues with good wound healing but also may be followed by serious complications which cause poor end-results, prolong hospitalization, and threaten life. Some of the complications that make surgery in irradiated tissue more difficult or hazardous are the following: (1) infection; (2) poor wound healing; (3) slough; (4) exposure of tendons, bone, or other important structures; (5) difficult hemostasis and or secondary hemorrhage; (6) difficult dissections; (7) rapid spread of carcinoma released from the incarceration of fibrosis; (8) radio-osteonecrosis; (9) induced tissue allergies; (10) narcotic addition from treatment for intolerable pain, and (11) general inanition. All these are fundamentally the result of diminished blood supply, lowered vitality of the irradiated tissue, and excessive fibrosis. Most all of these complications can and do follow surgery in normal tissues or in tissues damaged References 1. References 2, 3, and 4. 2. References 3 and 6. 3. Hempelmann, L. H.: Acute Radiation Injuries in Man , Surg., Gynec. & Obst. 93:385-403 ( (Oct.) ) 1951. 4. Lewis, S. R.: Management of Radiation Injuries , Am. Surgeon 18:842-850 ( (Aug.) ) 1952. 5. Brown, J. B.; McDowell, F., and Fryer, M. P.: Surgical Treatment of Radiation Burns , Surg., Gynec. & Obst. 88:609-622 ( (May) ) 1949. 6. Routledge, R. T.: The Surgical Problem of Local Post-Irradiation Effects , Brit. J. Plast. Surg. 7:134-152 ( (July) ) 1954. 7. Teloh, H. A.; Mason, M. L., and Wheeloch, M. C.: Histopathologic Study of Radiation Injuries of Skin , Surg., Gynec. & Obst. 90:335-348 ( (March) ) 1950. 8. Mason, M. L.: Irradiation Dermatitis of Hands , Am. Surgeon 17:1121-1131 ( (Dec.) ) 1951. 9. Mason, M. L.: Irradiation Injuries of the Hand , Quart. Bull. Northwestern Univ. M. School 25:51-59, 1951. 10. Converse, J. M.; Campbell, R. M., and Watson, W. L.: Repair of Large Radiation Ulcers Situated over Heart and Brain , Ann. Surg. 133:95-103 ( (Jan.) ) 1951. 11. White, W. C., and Finn, F. W.: Late Complications Following Irradiation of Pelvic Viscera , Am. J. Obst. & Gynec. 62:65-74 ( (July) ) 1951. 12. Cutler, M.: Problem of Extractions in Relation to Osteoradionecrosis Complicating Radiotherapy for Intraoral Cancer , Oral Surg. 4:1077-1090 ( (Sept.) ) 1951. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Archives Surgery American Medical Association

The Hazards of Surgery in Irradiated Tissue

ROBINSON, DAVID W.
A.M.A. Archives Surgery , Volume 71 (3) – Sep 1, 1955
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Publisher
American Medical Association
Copyright
Copyright © 1955 American Medical Association. All Rights Reserved.
ISSN
0096-6908
DOI
10.1001/archsurg.1955.01270150104012
Publisher site
See Article on Publisher Site

Abstract

Abstract Tissues subjected to irradiation undergo structural and physiologic changes often inexorably progressive. Surgical procedures may be performed in such tissues with good wound healing but also may be followed by serious complications which cause poor end-results, prolong hospitalization, and threaten life. Some of the complications that make surgery in irradiated tissue more difficult or hazardous are the following: (1) infection; (2) poor wound healing; (3) slough; (4) exposure of tendons, bone, or other important structures; (5) difficult hemostasis and or secondary hemorrhage; (6) difficult dissections; (7) rapid spread of carcinoma released from the incarceration of fibrosis; (8) radio-osteonecrosis; (9) induced tissue allergies; (10) narcotic addition from treatment for intolerable pain, and (11) general inanition. All these are fundamentally the result of diminished blood supply, lowered vitality of the irradiated tissue, and excessive fibrosis. Most all of these complications can and do follow surgery in normal tissues or in tissues damaged References 1. References 2, 3, and 4. 2. References 3 and 6. 3. Hempelmann, L. H.: Acute Radiation Injuries in Man , Surg., Gynec. & Obst. 93:385-403 ( (Oct.) ) 1951. 4. Lewis, S. R.: Management of Radiation Injuries , Am. Surgeon 18:842-850 ( (Aug.) ) 1952. 5. Brown, J. B.; McDowell, F., and Fryer, M. P.: Surgical Treatment of Radiation Burns , Surg., Gynec. & Obst. 88:609-622 ( (May) ) 1949. 6. Routledge, R. T.: The Surgical Problem of Local Post-Irradiation Effects , Brit. J. Plast. Surg. 7:134-152 ( (July) ) 1954. 7. Teloh, H. A.; Mason, M. L., and Wheeloch, M. C.: Histopathologic Study of Radiation Injuries of Skin , Surg., Gynec. & Obst. 90:335-348 ( (March) ) 1950. 8. Mason, M. L.: Irradiation Dermatitis of Hands , Am. Surgeon 17:1121-1131 ( (Dec.) ) 1951. 9. Mason, M. L.: Irradiation Injuries of the Hand , Quart. Bull. Northwestern Univ. M. School 25:51-59, 1951. 10. Converse, J. M.; Campbell, R. M., and Watson, W. L.: Repair of Large Radiation Ulcers Situated over Heart and Brain , Ann. Surg. 133:95-103 ( (Jan.) ) 1951. 11. White, W. C., and Finn, F. W.: Late Complications Following Irradiation of Pelvic Viscera , Am. J. Obst. & Gynec. 62:65-74 ( (July) ) 1951. 12. Cutler, M.: Problem of Extractions in Relation to Osteoradionecrosis Complicating Radiotherapy for Intraoral Cancer , Oral Surg. 4:1077-1090 ( (Sept.) ) 1951.

Journal

A.M.A. Archives Surgery – American Medical Association

Published: Sep 1, 1955

References

  • Acute Radiation Injuries in Man
    Hempelmann , L. H.
  • Management of Radiation Injuries
    Lewis , S. R.
  • Surgical Treatment of Radiation Burns
    Brown , J. B.; McDowell, F., and Fryer, M. P.
  • The Surgical Problem of Local Post-Irradiation Effects
    Routledge , R. T.
  • Histopathologic Study of Radiation Injuries of Skin
    Teloh , H. A.; Mason, M. L., and Wheeloch, M. C.
  • Irradiation Dermatitis of Hands
    Mason , M. L.
  • Irradiation Injuries of the Hand
    Mason , M. L.
  • Repair of Large Radiation Ulcers Situated over Heart and Brain
    Converse , J. M.; Campbell, R. M., and Watson, W. L.
  • Late Complications Following Irradiation of Pelvic Viscera
    White , W. C., and Finn, F. W.
  • Problem of Extractions in Relation to Osteoradionecrosis Complicating Radiotherapy for Intraoral Cancer
    Cutler , M.