V-Y Latissimus Dorsi Musculocutaneous Flap for Reconstruction of Radiation-induced Skin Injuries on the Back.

Shim, Seung Hyun; Chung, Chul Hoon; Kim, Kuyl Hee

Brief Communication

Journal of the Korean Society of Plastic and Reconstructive Surgeons 2011;38(5):707-710.
Published online September 1, 2011.

V-Y Latissimus Dorsi Musculocutaneous Flap for Reconstruction of Radiation-induced Skin Injuries on the Back.

Seung Hyun Shim, Chul Hoon Chung, Kuyl Hee Kim

Department of Plastic and Reconstructive Surgery, College of Medicine, Hallym University, Seoul, Korea. c21ps@hanmail.net

Abstract

PURPOSE
Cardiac radiofrequency catheter ablation procedures using fluoroscopy were performed for the treatment of supraventricular and selected ventricular tachyarrhythmia. Fluoroscopy is used to localize the position of the intracardiac catheter. Fluoroscopically- guided procedures often involve high radiation doses to patient's skin, but the incidence of serious radiation injuries in these patients is rare. We reported two cases of severe postradiation skin injury on the back treated with the V-Y latissimus dorsi musculocutaneous flap. METHODS: These two patients underwent radiofrequency catheter ablation under the diagnosis of Woff Parkinson White syndrome(WPW syndrome). They had radiation- induced skin injuries on the subscapular area and these lesions represented chronic ulceration, surrounding induration, hardness, and dyspigmentation. We treated these lesions with complete excision and coverage with V-Y latissimus dorsi musculocutaneous flap.
RESULTS
These two patients had no recurrence and no special complications during 20 months and 12 months follow-up periods and were satisfied aesthetically and functionally.
CONCLUSION
V-Y latissimus dorsi musculocutaneous flap obtained better results functionally and aesthetically compared with conservative management and skin graft in severe radiation-induced skin injuries after cardiac radiofrequency catheter ablation procedure.

Keywords: Radiation injury; V-Y latissimus dorsi musculocutaneous flap; Fluoroscopically-guided procedures