| Summary: | Radiation wounds are very difficult to manage due to poor vascular status, excessive matrix metalloproteinases, and abnormal myofibroblast function. Such wound beds do not adequately support conventional resurfacing as do nonradiate beds. We present a 46-year-old female with a sacral radiation ulcer, which had earlier failed to support flap cover on two instances after bed preparation with conventional honey dressing and negative pressure dressing, but was subsequently successfully managed with unripe pawpaw wound bed preparation. A re-elevation of the right gluteal myocutaneous flap proved successful and satisfactory. The finding may have resulted from both enzymatic properties of unripe pawpaw and its ability to break the biofilms and to locally supply the ascorbic acid necessary for collagen synthesis and granulation tissue formation.
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