{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T11:49:02Z","timestamp":1788263342702,"version":"build-2803163510"},"reference-count":49,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2014,1,1]],"date-time":"2014-01-01T00:00:00Z","timestamp":1388534400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Advances in Wound Care"],"published-print":{"date-parts":[[2014,1]]},"abstract":"<jats:sec>\n                    <jats:title>Significance:<\/jats:title>\n                    <jats:p>Patients with cancer receive benefits from radiation therapy; however, it may have adverse effects on normal tissue such as causing radiation-induced ulcer and osteoradionecrosis. The most reliable method to treat a radiation ulcer is wide excision of the affected tissue, followed by coverage with well-vascularized tissue. As usual, radiation-induced skin ulcers are due to therapeutic irradiation for residual cancer or lymph nodes; the locations of radiation ulcers are relatively limited, including the head, neck, chest wall, lumbar, groin, and sacral areas. Thus, suitable reconstructive methods vary according to functional and aesthetic conditions. I reviewed the practices and surgical results for radiation ulcers over the past 30 years, and present the recommended surgical methods for these hard-to-heal ulcers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Recent Advances:<\/jats:title>\n                    <jats:p>At a minimum, flaps are required to treat radiation ulcers. Surgeons can recommend earlier debridement, followed by immediate coverage with axial-pattern musculocutaneous and fasciocutaneous flaps. Free flaps are also a useful soft tissue coverage option. The choice of flap varies with the location and size of the wounds.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Critical Issues<\/jats:title>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic toggle=\"yes\">:<\/jats:italic>\n                      <\/jats:bold>\n                      The most crucial procedure is the complete resection of the radiation-affected area, followed by coverage with well-vascularized tissue.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Future Directions<\/jats:title>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic toggle=\"yes\">:<\/jats:italic>\n                      <\/jats:bold>\n                      Recent developments in perforator flap techniques, which are defined as flaps with a blood supply from isolated perforating vessels of a stem artery, have allowed the surgeons to successfully resurface these difficult wounds with reduced morbidity.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/wound.2012.0405","type":"journal-article","created":{"date-parts":[[2013,7,16]],"date-time":"2013-07-16T13:31:59Z","timestamp":1373981519000},"page":"25-37","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":58,"title":["Surgical Reconstruction of Radiation Injuries"],"prefix":"10.1177","volume":"3","author":[{"given":"Masaki","family":"Fujioka","sequence":"first","affiliation":[{"name":"Nagasaki University","place":["Japan"]},{"name":"National Hospital Organization Nagasaki Medical Center","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2014,1]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"crossref","first-page":"1081","DOI":"10.1016\/S0039-6109(16)44939-X","article-title":"Reconstruction of the radiation-damaged chest wall","volume":"69","author":"Arnold PG","year":"1989","unstructured":"Arnold PG, and Pairolero PC: Reconstruction of the radiation-damaged chest wall. 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