Here we report on the interventions taken to treat a patient exposed to high-dose radiation and provide a protocol for treating such patients in the future. The patient, Mr. Wang, was a 58-year-old male janitor who was accidentally exposed to a 192Ir source with an activity of 966.4 GBq or 26.1 Ci. The dose estimated to the lower right limb was 4,100 Gy, whereas the whole-body effective dose was 1.51 Gy. The diagnosis was made according to the results of the patient dose estimation and clinical manifestations. Systemic treatment included stimulating bone marrow hematopoietic cells, enhancing immunity, anti-infection and vitamin supplements. The treatment of radiation-induced skin lesions consisted of several debridements, two skin-flap transplantations and application of mesenchymal stem cells (MSCs). Skin-flap transplantations and MSCs play important roles in the recovery of skin wound. A combination of antibiotics and antimycotic was useful in reducing inflammation. The application of vacuum sealing drainage was effective in removing necrotic tissue and bacteria, ameliorating ischemia and hypoxia of wound tissue, providing a fresh wound bed for wound healing and improving skin or flap graft survival rates. The victim survived the accident without amputation, and function of his highly exposed right leg was partially recovered. These results demonstrate the importance of collaboration among members of a multidisciplinary team in the treatment of this patient.
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1 June 2019
Research Article|
March 29 2019
Successful Rescue of the Victim Exposed to a Super High Dose of Iridium-192 during the Nanjing Radiological Accident in 2014
You-you Wang
;
You-you Wang
1
a Departments of Nuclear and Radiation Incident Medical Emergency Office
d Departments of State Key Laboratory of Radiation Medicine and Protection
e School of Radiation Medicine and Protection, Soochow University, Suzhou 215004, China
f Collaborative Innovation Center of Radiation Medicine of Jiangsu Higher Education Institutions, Suzhou 215004, China
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Dao-jiang Yu
;
Tian-lan Zhao
;
Tian-lan Zhao
b Departments of Plastic Surgery
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Hong Dai
;
Hong Dai
a Departments of Nuclear and Radiation Incident Medical Emergency Office
d Departments of State Key Laboratory of Radiation Medicine and Protection
e School of Radiation Medicine and Protection, Soochow University, Suzhou 215004, China
f Collaborative Innovation Center of Radiation Medicine of Jiangsu Higher Education Institutions, Suzhou 215004, China
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Yuan Li
;
Yuan Li
c Departments of Oncology and Occupational Medicine, Second Affiliated Hospital of Soochow University, Suzhou 215004, China
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Hua-hui Bian
;
Hua-hui Bian
a Departments of Nuclear and Radiation Incident Medical Emergency Office
d Departments of State Key Laboratory of Radiation Medicine and Protection
e School of Radiation Medicine and Protection, Soochow University, Suzhou 215004, China
f Collaborative Innovation Center of Radiation Medicine of Jiangsu Higher Education Institutions, Suzhou 215004, China
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Wei-bo Chen
;
Wei-bo Chen
a Departments of Nuclear and Radiation Incident Medical Emergency Office
d Departments of State Key Laboratory of Radiation Medicine and Protection
e School of Radiation Medicine and Protection, Soochow University, Suzhou 215004, China
f Collaborative Innovation Center of Radiation Medicine of Jiangsu Higher Education Institutions, Suzhou 215004, China
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Yu-song Zhang
;
Yu-song Zhang
a Departments of Nuclear and Radiation Incident Medical Emergency Office
d Departments of State Key Laboratory of Radiation Medicine and Protection
e School of Radiation Medicine and Protection, Soochow University, Suzhou 215004, China
f Collaborative Innovation Center of Radiation Medicine of Jiangsu Higher Education Institutions, Suzhou 215004, China
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Wang-yang Pu
;
Wang-yang Pu
c Departments of Oncology and Occupational Medicine, Second Affiliated Hospital of Soochow University, Suzhou 215004, China
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Jun-chao Feng
;
Jun-chao Feng
a Departments of Nuclear and Radiation Incident Medical Emergency Office
d Departments of State Key Laboratory of Radiation Medicine and Protection
e School of Radiation Medicine and Protection, Soochow University, Suzhou 215004, China
f Collaborative Innovation Center of Radiation Medicine of Jiangsu Higher Education Institutions, Suzhou 215004, China
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Wen-tao Hu
;
Wen-tao Hu
d Departments of State Key Laboratory of Radiation Medicine and Protection
e School of Radiation Medicine and Protection, Soochow University, Suzhou 215004, China
f Collaborative Innovation Center of Radiation Medicine of Jiangsu Higher Education Institutions, Suzhou 215004, China
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Yu-long Liu
Yu-long Liu
2
a Departments of Nuclear and Radiation Incident Medical Emergency Office
d Departments of State Key Laboratory of Radiation Medicine and Protection
e School of Radiation Medicine and Protection, Soochow University, Suzhou 215004, China
f Collaborative Innovation Center of Radiation Medicine of Jiangsu Higher Education Institutions, Suzhou 215004, China
2Address for correspondence: Nuclear and Radiation Incident Medical Emergency Office, The Second Affiliated Hospital of Soochow University, Gusu Area, Sanxiang Road No.1055, Suzhou, Jiangsu 215004, China; email: yulongliu2002@126.com.
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Radiat Res (2019) 191 (6): 527–531.
Article history
Received:
October 16 2018
Accepted:
March 04 2019
Citation
You-you Wang, Dao-jiang Yu, Tian-lan Zhao, Hong Dai, Yuan Li, Hua-hui Bian, Wei-bo Chen, Yu-song Zhang, Wang-yang Pu, Jun-chao Feng, Wen-tao Hu, Yu-long Liu; Successful Rescue of the Victim Exposed to a Super High Dose of Iridium-192 during the Nanjing Radiological Accident in 2014. Radiat Res 1 June 2019; 191 (6): 527–531. doi: https://doi.org/10.1667/RR15274.1
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