Management of Coccygeal Radiation-Induced Ulcer Using Injectable Acellular Dermal Matrix Combined with Negative Pressure Wound Therapy: A Case Report

Abstract

Radiation ulcers can occur as a complication following exposure to ionizing radiation. Advances in medical technology, followed by the wider range of radiation application in recent decades has steadily increased the incidence of radiation ulcers. Radiation causes hypoxia, hypovascularity, and hypocellularity in tissues. Moreover, the surrounding skin adjacent to the radiation ulcer lacks follicular stem cells and is more prone to chronic, non-healing wounds. While no guidelines have been established regarding optimal treatment, management facilitating angiogenesis and migration of fibrogenic cells can be a recommended option, considering the etiology of ulcers induced by radiation exposure. Herein, we present a patient exposed to prolonged radiation during a fluoroscopic intervention procedure, who had developed a vast radiation ulcer at his coccyx, and was completely treated with injectable acellular dermal matrix combined with 14 weeks of negative pressure wound therapy.