Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with a chronic, non-healing ulcer in a previously irradiated field. History of radiotherapy for [Primary Malignancy] completed [Date/Duration]. Symptoms include [Pain/Pruritus/Exudate/Odor]. No signs of acute infection or systemic sepsis. Progression characterized by [Slow expansion/Recurrent breakdown].
Clinical Examination Findings
Examination of the irradiated site reveals a [Size: cm x cm] ulcer with [Indurated/Fibrotic/Atrophic] wound edges. Base of the ulcer shows [Granulation tissue/Necrotic slough/Exposed bone or cartilage]. Surrounding skin exhibits telangiectasia, hyperpigmentation, and subcutaneous fibrosis. Assessment of vascularity and tissue pliability performed. No palpable regional lymphadenopathy.
Treatment Protocol
Debridement of necrotic tissue and biopsy to rule out malignant transformation (recurrent or secondary). Optimization of local wound care with [Hydrogel/Alginate/Antimicrobial dressings]. Surgical planning for reconstruction using [Local flap/Regional pedicled flap/Free tissue transfer] based on defect size and vascularity. Hyperbaric oxygen therapy (HBOT) considered for refractory cases.