RADIATION NECROSIS

Intensive treatments with chemotherapeutic drugs and/or radiation may impair the body’s ability to build new tissue, fight infection, and maintain integrity of the skin. Radiation destroys the microvasculature, decreasing blood flow to the wounded area. Other factors that are known contributors to poor wound healing might also be present in patients diagnosed with cancer. General debility, advanced age, and poor nutritional status are just a few. With these underlying risk factors present, seemingly insignificant wounds may heal poorly, or not at all. If skin wounds do form, standard wound care techniques may be ineffective and advanced wound therapy, including bioengineered skin grafts or hyperbaric oxygen treatment, may be required in order to achieve healing.

Radiation damaged tissue has lost blood supply and is oxygen deprived. Chronic radiation complications result from scarring and narrowing of the blood vessels within the area which has received the treatment. Patients with head and neck cancer may have been treated with radiotherapy that has damaged the jawbone and adjacent tissues. This patient population is encouraged to have a thorough dental checkup before undergoing radiation to the area. If during the course of their cancer treatment, bone is injured by radiation, the diagnosis is called osteoradionecrosis. If teeth need to be extracted post-radiation patients benefit from 20 hyperbaric oxygen prior to dental work and then 10 treatment post operatively.

When muscle or skin is injured the condition is called soft tissue radionecrosis. Patients who receive pelvic radiation for prostate, bladder or gynecologic cancers may also be at risk for ulceration and chronic bleeding from the rectum or bladder. These complications from radiation are often delayed, occurring 5-10 years post radiation therapy. Hyperbaric oxygen treatment may be successful in treating these conditions when other therapies have been ineffective. Hyperbaric oxygen therapy provides a better healing environment and leads to the growth of new blood vessels in a process called re-vascularization.

It also fights infection by direct bacteriocidal effects. Breast cancer patients respond well to hyperbaric oxygen therapy when the surgical or reconstruction site fails to heal. Supplying the wound bed with oxygen to the irradiated tissue causes new vessels to generate, supporting wound healing.

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