Page 34 - APPENDIX B: Trials Investigating the Management of Acute Radiation-Induced Skin Reactions Reading Qualitative Research

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WOUND CARE

for the care of the patient, heads the treatment planning team” (p. 7). According to the author, it

is implied that the Radiation Therapy Nurse (RTN) is part of the clinical team, but not directly

part of the treatment planning process. An examination of quality practice environment by

Girouard (2004) defines process as “Methods in which health care is provided; provider

behaviors; includes technical and inter-personal elements” (p. 500). This directs one to further

explore the perceived role of the radiation therapy nurse in an inter-professional practice context

such as radiation oncology, which is addressed in the subsequent part of this study. The

following articles are relevant to this study because they highlight the tests done to precisely

estimate the effect of radiating through dressings.

Thilmann et al. (1996) used thermo luminescent dosimetry to quantify the increase in

surface dose from a silicone coated polyamide wound dressing (Mepitel®, Silk acetate

(Cuticerin*), Hydrocolloid (Varihesive®, extra thin) and Ca-Na-alginate (Kaltostat®). The

investigation led to the conclusion that wound dressings could be used during electron beam

irradiations with no significant change to skin dose; however only very thin dressings could be

used during high energy photon irradiations. Other relevant findings are summarized as follows:

1) Non-adhesive silk acetate wound dressings are recommended for moist desquamation

as they help to protect the damaged skin, aid healing and do not cause skin to feel more

irritated; 2) Silicon-coated polyamide dressing has the disadvantage that it is often

removed inadvertently, but the relative dose increase caused is lower; 3) Alginate wound

dressings can be used for heavily oozing wounds. The wound dressing’s absorbent

material and the wound secretion form a film which, depending on the stage of the

secretion of the wound, can be up to 2 mm. thick; 4) With electron therapy, the dose

increase through a wound dressing is small (3-7%). Any of the wound dressings can be