[Clinical Case] Successful Reconstruction of Severe Radiation Ulcer via MDT to Resume Oncology Treatment

1. Clinical Challenges The patient presented with a massive axillary radiation ulcer following treatment for metastatic cervical cancer. Clinical complications included severe localized infection (200ml daily drainage) and a history of hemorrhagic shock. The surgical site was characterized by poor regenerative capacity due to radiation damage and proximity to the axillary neurovascular bundle, posing a high risk of intraoperative hemorrhage.

2. Treatment Strategy The Reconstructive Surgery team at Peking University Shougang Hospital implemented a staged MDT approach:

• Phase I: Conservative debridement combined with VSD (Vacuum Sealing Drainage) and continuous irrigation to reduce bacterial load and inflammatory mediators.
• Phase II: Precision debridement via Hydrosurgical system followed by a latissimus dorsi musculocutaneous flap transfer to provide vascularized tissue coverage for the defect.

3. Clinical Outcomes Two weeks post-operation, the flap demonstrated 100% viability with complete wound closure. The successful reconstruction eliminated the risks of infection and hemorrhage, successfully clearing the path for the patient to resume systemic oncology therapy, thereby significantly improving the clinical prognosis.