Abstract : Radiation therapy is being used with increasing frequency for treatment of cancer and other disease etiologies. Despite the benefits of radiotherapy, the resultant chronic changes may be lifelong and cumulative, which will need reconstruction with well vascularized, undamaged tissues. Ten patients (5 males and 5 females) with radionecrosis and osteoradionecrosis complex wounds were treated with myocutaneous flaps after radical debridement. The results revealed sound healing in seven out of the ten patients. Persistent sinus remained in two patients and major flap necrosis in one patient. In conclusion, the guidelines for surgical management of radiation injuries are debridement of necrotic tissues, coverage with myocutaneous flap, obliteration of dead space, rule out recurrence of malignancy, restore function, and keep in mind another solution if the first flap fail