Page 39 - APPENDIX B: Trials Investigating the Management of Acute Radiation-Induced Skin Reactions Reading Qualitative Research

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WOUND CARE

reactions. “Compared with aqueous cream, Mepilex® Lite dressings reduced the overall severity

of skin reaction by 41% (p<0.001), the incidence of moist desquamation from 19% to 15%, the

average moist desquamation score from 0.37 to 0.18 (p= 0.043) and the total moist desquamation

time for all areas combined by 28% from 25 to 18 weeks” (Bennett, p. 46). However, it is not

clear if the dressings were left in place during the radiation therapy.

In an associated small trial (n=10) by Paterson (2012) the Mepilex® Lite dressings were

removed during treatment because they may have obscured treatment positioning tattoos in some

patients. The aim of this trial was to investigate whether Mepilex® Lite dressings are superior to

standard care in reducing the extent of radiation dermatitis in patients with breast cancer post

mastectomy. Modified Radiation-Induced Skin Reaction Assessment Scale (RISRAS) was used

to assess the treatment area with the inclusion of a patient component that rated discomfort,

itchiness, burning and effect on daily life. There was a small, statistically significant

improvement in the average erythema rating under the Mepilex® Lite dressing. The study

concluded that the dressing was found to promote comfort and reduce subjective symptoms of

acute radiodermatitis. The conclusions of this small-scale study need to be tested with a larger

study with greater power.

Chan, Larsen, and Chan (2012) reexamined the evidence in radiation dermatitis

management literature by appraising previous systematic reviews. According to Chan et al.,

“Four reviews examined the use of dressings” and “concluded that there is limited evidence from

investigations of the efficacy of dressings” (p. e 360). Kedge (2009) recommended that there

may be advantages to using moisture-vapor-permeable dressings, however further research is

necessary. Salvo et al. (2010) described that hydrogel dressing was not beneficial for radiation

dermatitis as it had a significantly longer healing time than dry dressing. In a comparison