PEDICLE MUSCLE FLAPS IN IRRADIATED WOUNDS: DOES PREVIOUS RADIATION OF THE MUSCLE TO BE TRANSPOSED-AFFECT THE OUTCOME? A 9 YEARS EXPERIENCE OVER 206 CONSECUTIVE CASES

Radiation-related wounds challenge surgeons in all disciplines of surgery. Wound-healing complications are commonplace, and solutions for reconstruction are limited. Muscle and musculocutaneous flaps have improved this situation. But the question is, does previous radiation of the muscle to be transposed affect the outcome? 143 consecutive previously irradiated patients treated with muscle or musculocutaneous flaps composed the group under consideration: these 143 patients had 206 muscles transposed. The overall complication rate for muscle transposition to close a radiated wound was 20 percent. Of the 143 patients who received radiation, 62 patients had the muscle transposed for wound closure from the primary field of radiation. 81 patients were closed with non-irradiated muscle. When the transposed muscle had been radiated, the complication rate was 29.6 percent in 14.3 percent, the entire muscle underwent necrosis, requiring total removal and a second tissue transposition from a non-irradiated source to achieve closure. The subgroup using non-irradiated muscle had a complication rate of 12.2 percent 1 patient in this group had complete flap necrosis requiring a second tissue transposition. No postoperative deaths were encountered. The experience in our department reveals that non-irradiated muscle is the best choice for closure of a radiated wound, if possible.