Читать книгу Veterinary Surgical Oncology - Группа авторов - Страница 52

Ionizing radiation damages fibroblasts and blood vessels, two critical players in wound healing. After irradiation, collagen displays reduced proliferation, abnormal maturation, and swelling – changes that lead to significantly weaker collagen scaffolding in the wound bed. Furthermore, irradiation induces acute degenerative changes in the basement membranes of blood vessels, thus increasing vascular permeability. Later changes seen in irradiated vasculature include hemostasis and occlusion, edema of the vascular wall, thrombosis, reduced neovascularization, and vascular sclerosis, which can be permanent. Eventually, progressive vascular loss and replacement by fibrous tissue may occur. These fibrous and vascular changes can predispose the patient to a higher risk of both immediate and delayed wound healing complications (Seguin et al. 2005). In general, the late tissue changes caused by radiation are more severe and impactful compared to those seen in the acute phases.