Page 94 - APPENDIX B: Trials Investigating the Management of Acute Radiation-Induced Skin Reactions Reading Qualitative Research

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WOUND CARE

be the case, there is variability in the types of dressings that were investigated. Overall, the

suggestion is to examine the condition of the dressing prior to irradiation. A radiation oncologist

commented that one cannot make a simple statement that removing wound dressings is best

practice or not, because there are different types of wounds and different types of dressings

(personal communication, August 25, 2013). It was also recommended to define different

wound scenario namely radiation dermatitis and malignant wounds, provide rationale for pros

and cons of dressing removal, develop draft guidelines and seek feedback from multiple

disciplines for further research and practice. It is noteworthy that an assumption of bolus effect

related to the thickness and consistency of dressings has and continues to guide practice.

In summary, there is little evidence in relation to deciding if radiating through dressings

is best practice. More research needs to address specific wound care products that might be left

in place during radiation without causing a significant boost effect or harm to patient. Also

helpful would be the development of an expert consensus-developed decision-making algorithm.

In the context of clinical inquiry, examining current practice is crucial in gathering any other

existing evidence.

Question # 2: Current practice in cancer agencies across Canada. All phases of the

study addressed the question regarding current wound care practices in Radiation Oncology

Centres across Canada. As explained in Chapter Four, the national environmental scan survey

results reveal that dressing use is similar for radiation induced skin reactions and malignant

wounds during radiotherapy. Though dressings are sometimes left in place during radiotherapy,

in fact radiating through wound dressings is not yet standardized anywhere.

Inconsistency in practice. In this study, findings revealed that practices in relation to

radiating through dressings varied considerably across centres in Canada. While dressings are