Tissues subjected to irradiation undergo structural and physiologic changes often inexorably progressive. Surgical procedures may be performed in such tissues with good wound healing but also may be followed by serious complications which cause poor end-results, prolong hospitalization, and threaten life. Some of the complications that make surgery in irradiated tissue more difficult or hazardous are the following: (1) infection; (2) poor wound healing; (3) slough; (4) exposure of tendons, bone, or other important structures; (5) difficult hemostasis and or secondary hemorrhage; (6) difficult dissections; (7) rapid spread of carcinoma released from the incarceration of fibrosis; (8) radio-osteonecrosis; (9) induced tissue allergies; (10) narcotic addition from treatment for intolerable pain, and (11) general inanition. All these are fundamentally the result of diminished blood supply, lowered vitality of the irradiated tissue, and excessive fibrosis.
Most all of these complications can and do follow surgery in normal tissues or in tissues damaged
ROBINSON DW. The Hazards of Surgery in Irradiated Tissue. AMA Arch Surg. 1955;71(3):410-418. doi:10.1001/archsurg.1955.01270150104012