In the minds of many physicians, a major surgical procedure following intensive irradiation entails considerable risk of increased postoperative morbidity, a concept especially prevalent in the treatment of cancer of the head and neck. Partially for this reason, radiation has often been reserved for surgical failures rather than attempting a radiation cure initially. It is not uncommon to observe both house staff and experienced surgeons attribute any postoperative complication occurring in or near an irradiated area to "radiation effects."
With the newer radiation modalities and techniques, the damage to vasculoconnective tissue can be greatly reduced, which should lead to less delay in wound healing and less postoperative morbidity. It is the opinion of many therapists and a few surgeons,1,2,4-7,10-13 that the postoperative morbidity after competent irradiation differs little from that of the surgical procedure alone, but there is little published experience to substantiate this opinion, especially for high-energy (super-voltage)
DITCHEK T, LAMPE I. Radical Surgery After Intensive High-Energy Irradiation. Arch Surg. 1963;86(4):534-539. doi:10.1001/archsurg.1963.01310100018003