Page 41 - APPENDIX B: Trials Investigating the Management of Acute Radiation-Induced Skin Reactions Reading Qualitative Research
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WOUND CARE
worn during treatment using high-energy x-rays. Accordingly the authors concluded that there is
no significant bolus effect or increased surface dose with normal application of deodorants,
creams or powders (p.450). In a similar recent investigation by Morley, Cashell, Sperduti,
McQuestion, and Chow (2013) to determine the thickness of skin product necessary to produce
clinically meaningful dose increase to the skin and provide recommendations for evidence-based
patient instructions, the authors recommend that there are no dosimetric reasons to restrict the
use of water-based moisturizer or silicon-based barrier cream, considering that a typical
application of product would be only 0.3 mm. (p. 1 & 7).
Niazi et al. (2012) conducted a phase III randomized trial to compare the efficacy of
Silver Clear Nylon Dressing (SCND) with that of standard skincare in patients with lower
gastrointestinal cancer. A total of 42 patients with the rectal or anal cancer were randomized to
either SCND or standard skincare group. All patients randomized to SCND wore the dressing
from day one of radiation therapy except during radiotherapy. All patients in the control arm
used sulfadiazine cream at the time of development of grade 1 skin dermatitis per institutional
standard. Patients were advised to wash the cream off at least four hours prior to radiation
therapy. The authors conclude that SCND is effective in reducing radiation-induced dermatitis
in patients with lower gastrointestinal cancer treated with combined chemotherapy and radiation
treatment.
Summary of Literature Review
In summary, it is noted that the quest to determine which dressings can be left in place
has been explored by authors for a period of over 18 years. Based on the current state of
knowledge and synthesis of evidence regarding radiating through dressings, it appears that a few
