title: Supplementation of bone marrow aspirate-derived platelet-rich plasma for treating radiation-induced ulcer after cardiac fluoroscopic procedures: A preliminary report.
abstract: BACKGROUND
  The frequency of encountering radiodermatitis caused by X-ray fluoroscopic procedures for ischaemic heart disease is increasing. In severe cases, devastating ulcers with pain, for which conservative therapy is ineffective, emerge. Radiation-induced ulcers are notorious for being difficult to treat. Simple skin grafting often fails because of the poor state of the wound bed. A vascularized flap is a very good option. However, the non-adherence of the well-vascularized flap with the irradiated wound bed is frequently experienced.
  
  
  OBJECTIVE
  To ameliorate the irradiated wound bed, bone marrow-derived platelet-rich plasma (bm-PRP) was delivered during the surgery.
  
  
  METHODS
  Four patients with severe cutaneous radiation injury accompanied by unbearable pain after multiple fluoroscopic procedures for ischaemic heart disease were treated. Wide excision of the lesion and coverage with a skin flap supplemented with bm-PRP injection was performed.
  
  
  RESULTS
  All patients obtained wound closure and were relieved from pain. No complication concerning the bone marrow aspiration and delivery of bm-PRP was observed.
  
  
  CONCLUSIONS
  Supplementation of bm-PRP can be an option without major complications, time, and cost to improve the surgical outcome for irradiated wounds.
authors: Department of Plastic Surgery, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
authors: Soh
authors: S
authors: Nishimoto
authors: Kenji
authors: K
authors: Fukuda
authors: Kenichiro
authors: K
authors: Kawai
authors: Toshihiro
authors: T
authors: Fujiwara
authors: Tomoko
authors: T
authors: Tsumano
authors: Kazutoshi
authors: K
authors: Fujita
authors: Masao
authors: M
authors: Kakibuchi