Exposure to an iridium-192 source in an industrial safety worker.
Radiation burn injuries account for 0.2% of burn injury admissions. Treatment of radiation burns remains challenging because of unpredictable inflammatory changes and soft tissue necrosis. Conventional treatment consists of multistaged surgical procedures. Here, we present a case of an Iridium-192 exposure treated nonoperatively. A 23-year-old man presented with a 7-day-old, less than 1% TBSA radiation burn to his right hand. He initially sought treatment at an outside hospital and plastic surgeon's office postinjury days 2 and 3. He later presented to our facility because of worsening pain, edema, and discoloration. He was admitted and hospitalized for 15 days. Narcotics were initiated and wound care consisted of daily antibiotic ointment and petroleum gauze dressings. We continued dexamethasone and pentoxyfilline for 1 week. He underwent nineteen 90-minute treatments of hyperbaric oxygen therapy during an 8-week period. He had complete wound healing 1 month postdischarge. This case report provides background on radiation burn injuries and applicability of nonoperative management in treating radiation burn injuries. Furthermore, it encourages the development of individualized treatment plans, consideration of the use of hyperbaric oxygen therapy, referral to a burn center, and consulting radiation experts for guidance.
From the Department of Surgery, University of Texas Health Science Center at Houston, Memorial Hermann Hospital, John S. Dunn Sr. Burn Center.
Tonya C
TC
George
Todd F
TF
Huzar
James M
JM
Cross
D002056:Burns / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D003131:Combined Modality Therapy; D005500:Follow-Up Studies; D006230:Hand Injuries / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D006931:Hyperbaric Oxygenation / Q000379:methods*; D015601:Injury Severity Score; D007495:Iridium / Q000009:adverse effects*; D008297:Male; D016273:Occupational Exposure / Q000009:adverse effects*; D016272:Occupational Health; D011832:Radiation Injuries / Q000175:diagnosis / Q000628:therapy*; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology; D055815:Young Adult
D007495:Iridium