Page 35 - APPENDIX B: Trials Investigating the Management of Acute Radiation-Induced Skin Reactions Reading Qualitative Research

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WOUND CARE

left on the skin during electron irradiation, but its thickness should be taken into account

when calculating the actual applied dose; 5) With photons, the dose increases depending

on the thickness of its tissue as noted with the polyamide and silk acetate dressings that

had equal increase in skin dose however; a slightly higher skin dose was measured for the

hydrocolloid wound dressing; and 6) For ulcerating tumor, all non-adhesive wound

dressings whose clinical aptitude for the treatment of ulcerating tumors have been proven

can be used regardless of their dosimetric characteristic. Wound dressings can be left on

the skin without increasing the risk of an aggravated skin reaction. This has to be taken

into account while calculating the actual applied dose. (Thilmann et al., 1996, p. 183)

Other scholars have varied in their views regarding radiating through dressings.

Mendelsohn, Divino, Reis, and Kerstein (2002) posit, “The ability to irradiate through

thicker dressings without creating a possible, but unverified, bolus effect remains to be explored”

(p. 219). In a dosimetry study, Butson, Cheung, Yu ,and Metcalfe (2002) measured skin dose

variations produced by a silicon-based protective dressing, Mepitel®, by using thermo

luminescent dosimeters, parallel plate ionization chambers and Gafchromic film. Increases in

skin dose produced by the silicon dressing ranges were reported. According to the authors, the

effective thickness of the dressing was calculated to be 0.5 mm. water equivalence (p. 151).

Mac Nally and Woodings (2012) conducted a study (see Literature review: Appendix A)

using Allevyn◊ average (dry and wet), Mepilex® border (dry and wet), Mepilex® lite (dry and

wet), duoderm® dry and fixomull® (dry and wet). The study led to the conclusion that the state

of the dressing must be examined prior to patient treatment, particularly in the case of exudating

wounds (p. 249). According to the study, for electron beams there were no clinically significant

effects at the surface; whereas for photon beams the presence of a dressing caused a clinically