Page 36 - APPENDIX B: Trials Investigating the Management of Acute Radiation-Induced Skin Reactions Reading Qualitative Research

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WOUND CARE

significant increase in dose at surface. However for most dressings, there were no clinically

significant effects measured at depth for both photon and electron beams energies.

The studies reflect an opinion that thin dressings (up to 2 mm.) may be left in place

during radiotherapy. While this may be the case, there is variability in the types of dressings that

were investigated. Overall, the suggestion that the condition of the dressing must be examined

prior to irradiation leads one to further consider the most favorable wound dressings for

irradiation.

Moisture-vapor-permeable dressings. In a literature review by Naylor and Mallett

(2001), semi-permeable film dressings were recommended for moist desquamation in clinical

papers by Blackmar (1997), Dunne-Daly (1995), and Gallagher (1995) on the basis that the film

can be left in place during radiotherapy treatment and reduces discomfort. The clinical trial by

Adamietz et al. (1995) in which Mepitel® a non-adherent dressing was evaluated in 21 patients

revealed that though the dressing caused an increase in the radiation dose to the skin, it did not

result in increased skin reaction. Accordingly, Naylor and Mallett (2001) recommended that

semi-permeable film dressings may be applied to areas of low or no exudate and left in place

during treatment as they will reduce pain and can be easily removed.

Adamietz et al. (1995) demonstrated the effect of self-adhesive silicone coated polyamide

net dressing (Mepitel®) on irradiated human skin. A small sample size of 21 patients’ tolerance

of dressing strips was good and there were no reactions to the adherent dressing net by non-

irradiated skin. According to the authors, no additional skin irritation due to the tested material

was observed in the irradiated region and the ulcers covered by silicone-coated dressings re-

epithelialized quickly during radiotherapy. Further, there was no injury to new epithelium