Radiation Ulcers Workup
- Author: Martha Matthews, MD; Chief Editor: Joseph A Molnar, MD, PhD, FACS more...
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- Routine presurgical testing should be done, as indicated by the patient's age and comorbid conditions.
- Nutritional parameters, such as albumin, prealbumin, and ferritin levels, should be obtained if suboptimal nutrition is a possibility.
- Patients with chronic wounds are often debilitated, and they may have anemia due to chronic, minor blood loss.
- Check the prealbumin and albumin levels, which indicate whether the patient's wound healing capability is optimized.
Plain radiographs may be useful to look at the condition of the underlying bone and to screen for osteoradionecrosis. Computed tomography (CT) scanning or magnetic resonance imaging (MRI) may be useful in defining the extent of large, deep wounds and the involvement of underlying muscle and bone.
A study by Chen et al indicated that MRI findings in postradiation necrosis following treatment for nasopharyngeal carcinoma strongly correlate to clinical findings. In the study, which involved 67 patients with pathologically diagnosed postradiation nasopharyngeal necrosis, MRI findings consistent with radiation injury included local and extensive erosion, carotid exposure, and osteoradionecrosis. Despite the necrotic characteristics revealed by MRI, however, the investigators cautioned that pathologic examination is still required for an accurate diagnosis of nasopharyngeal necrosis.
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- Biopsy of suspicious wounds should be done to rule out malignancy (Marjolin ulcer)
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