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WOUND CARE

are recommended for excessive drainage and are more acceptable to patients as they are less

bulky than other absorbent dressings such as abdominal pads (Cochran & Jakubek, 2010).

However, the dressing must be removed before daily treatment, and this removal may cause

more desquamation and pain (Sparks, 2007). In addition, the use of non-adherent absorbent

dressings and hydrocolloid dressings share a common problem in that both types of dressing

require daily removal before each fraction of radiation therapy and removal might cause more

damage to the skin integrity because of their different level of adherence (Mak et. al., 2005).

Removing wound dressings prior to daily radiation treatments can thus alter the wound bed or

healing process. Hydrocolloid dressings may melt and leak gel, if left in place during radiation

(Mak et al.). It is not clear if radiating through other non-adherent absorbent dressings will cause

a boost effect or harm to patients with cancer.

A number of clinical trials have investigated agents that create or preserve a moist wound

healing environment. A clinical update and literature review by McQuestion (2006, 2011) report

that though a number of authors have cited the use of dressings in the management of moist

desquamation, few studies exist evaluating the effects of hydrocolloids, semipermeable dressings

or hydrogels in the management of radiation skin reactions. See Appendix A and B.

Moisture retentive dressings. Hom, Adams, Koreis, and Maisel (1999) presented an

article on choosing the optimal wound dressing for irradiated soft tissue wounds. Although

general principles of wound care management apply, the authors recommend that adhesives

should be used sparingly to prevent epithelial injury and that the type of dressing chosen should

correspond to wound characteristics. Six moisture retentive dressing categories (i.e., gauze,

transparent film, foam, hydrocolloid, calcium alginate, and hydrogel dressings) are addressed.