Page 40 - APPENDIX B: Trials Investigating the Management of Acute Radiation-Induced Skin Reactions Reading Qualitative Research

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WOUND CARE

between hydrogel dressing and gentian violet in the management of moist desquamation, wound

size, and wound pain were significantly lower with gentian violet (Bolderston et al., 2006; Salvo

et al., 2010). However, there is no evidence supporting the use of gentian violet in terms of

healing time, pain, and comfort; and there are safety and patient comfort concerns associated

with its use (Kedge). Silver-leaf Nylon dressings were reported to be superior to silver

sulfadiazine cream in reducing skin reactions and pain (Kourkourakis, Kelekis, Kouvaris et al.,

2010; Salvo et al.). It is noteworthy that based on the common knowledge that silver is a metal,

wound care products with metallic properties are removed prior to radiation. I have not yet

found any literature evidence to support this practice.

Burch, Parker, Vann, and Arazie (1997) investigated the effect of deodorants, powders,

and creams when applied in the treatment area prior to radiation treatments. The study

investigated if an interaction occurs between the radiation and metallic elements such as

aluminum, magnesium or zinc found in deodorants and powders. Another rationale for the study

was the common belief that the product applied to the skin acts as a bolus. A Markus–type

parallel plate ionization chamber in a polystyrene phantom was used to measure surface doses

for normal application of the products for a small and large field size. They compared a set of

samples representing normal application thickness with a set of samples of extremely thick

application. The authors reported that no large increase in surface dose was detected with a

normal application of the products and possible increase in skin reaction may occur owing to

chemical irritants in the applied products (p. 447). Additionally, there were no differences

between metallic and nonmetallic deodorant or powder products in relation to the assumption of

boost effect. Though no patient trials were conducted, the authors claim that if the patient is not

sensitive or allergic to the product applied, skin reactions should not increase if products are