Page 15 - APPENDIX B: Trials Investigating the Management of Acute Radiation-Induced Skin Reactions Reading Qualitative Research

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WOUND CARE

texture and turgor” (Dest, 2010, p.141). Skin assessment is not only fundamental but essential

“in recognizing the right approach to nursing care” for “preventing further damage and

mediating skin problems” (Faithfull, p. 345). Several clinical documentation tools such as the

United States National Cancer Institute and the Radiation Therapy Oncology Group (RTOG)

criteria are used to assess radiation skin reactions (McQuestion, 2010, p.124).

Cancerous or fungating wounds. Malignant cutaneous disease or malignant fungating

wound is defined by the BCCA (2001) as,

a cancerous lesion involving the skin, which is open and may be draining; may be the

result of a primary cancer or metastasis to the skin from a local tumor or from a tumor in

a distant site and may take the form of a cavity, an open area on the surface of the skin,

skin nodules or a nodular growth extending from the surface of the skin. (Cochran &

Jakubek, 2010, p.77)

The aims of managing fungating wounds are to “control tumour growth, prevent and halt surface

bleeding and where possible, repair skin integrity” (Krishnaswamy, 2008, p. 494).

Wound management. Wound management is part of radiation therapy management that

is one of the “interventions from the Nursing Interventions Classification (NIC) defined as

assisting the patient to understand and minimize side effects of radiation treatments” (Mosby’s

Dictionary, 2009, p.1572). NIC is the continuum of activities that nurses perform on behalf of

patients including independent and collaborative interventions as well as both direct and indirect

care. NIC interventions are thereby considered inclusive of the ‘clinical decision-making’ of the

nurse to decide and document the nursing diagnoses, planned outcomes, interventions

implemented and outcomes achieved (Mosby’s p. 1303). Due to the plethora of wound care