Reconstruction for local radiation injuries and proposed regeneration therapy for acute systemic radiation injuries

Skin and soft tissue radiation injuries are life-threatening as well as of esthetic concern in local tissues. As for local radiation injuries, clinically developed procedures such as local flaps and free vascularized flaps result in better and less-invasive reconstructive outcomes for victims of therapeutic radiation of malignant tumors, prolonged fluoroscopic procedures for cardiovascular diseases or possibly direct contact with radioactive waste, while systemic radiation injuries should find other solutions. In systemic radiation injuries, there is a good chance to save lives when the initial treatment is efficient, although donors of the skin grafting after debridement of the radiation-damaged tissue removal are unrealistically autogenous. Thus, exceeding certain extent and degree, systemic radiation injury-induced burns were not the medical objectives. Recent understanding and application of use in adult stem cells, however, create a new insight for severe systemic radiation injuries. Among the adult stem cells, the human mesenchymal stem cells are able to be freeze-dried, easily thawed and able to be cultured in vitro. A basic fibroblast growth factor is already of clinical use and efficient for the human mesenchymal stem cell growth both in vitro and in vivo. An artificial dermis is useful for temporal coverage of the raw surface of severe bedsores. The combined use of these successfully regenerates both dermis and epidermis after 20 Gy whole body irradiation in a nude rat model. Therefore, even severe radiation injuries, local tissue management and therapy are well-handled and systemic radiation injury may be hopeful with understanding and the specialized practice of regenerative medicine.