Management of skin reactions during radiotherapy: a study of nursing practice

Abstract

The aim of this study was to investigate the consensus of skin care advice given by nurses during radiotherapy. Sixty-seven nurses, identified through nine Belgian radiotherapy departments, responded to a questionnaire survey consisting of 58 items regarding prevention and management of erythema, dry desquamation and moist desquamation. Consensus for a given advice was categorized as small if less than 50% of the nurses gave the same answer, as moderate if between 50% and 75% and as large when more than 75%. Overall, 33% of the items showed small consensus, 29% showed moderate consensus and 38% showed large consensus. The highest consensus was seen for advice in cases of moist and dry desquamation. There was less agreement in the case of erythema and it decreased further for preventive advice. Some skin care techniques that were frequently used by the nurses cannot be supported by the literature. Also, some techniques recommended by the literature are not frequently used. Further, few differences (P < 0.05) between nurses working in a university hospital and the ones working in a non-university hospital were found in terms of advice given to patients. To increase consensus on skin care issues more conclusive research is needed. Of equal importance is the translation of existing research results into daily clinical practice.

RTOG criteria to evaluate acute skin reaction and its risk factors in patients with breast cancer submitted to radiotherapy

“…There is little consensus between involved professionals, and knowledge advancements regarding the care of wounds have little impact on patients with skin reactions caused by radiation (16)(17)(18) .…”

Mepilex Lite dressings for the management of radiation-induced erythema: a systematic inpatient controlled clinical trial

“…It is generally accepted that maintaining a moist wound environment will facilitate healing. Although there are many creams and gels on the market that attract and trap moisture at the skin surface, there is a lack of clinical evidence to support the use of topical agents [1,3,8]. One of the most popular skin remedies, aloe vera, is commonly used by the lay public for the treatment of various ailments, including skin burns [9].…”

“…Most of these women will receive radiation therapy treatment, and skin reactions will occur in 80-90% of patients by treatment completion [1]. To date, there is no standard treatment for radiationinduced skin reactions and practice tends to be based on historical and anecdotal evidence [1][2][3]. A promising new range of Swedish silicon-foam skin dressings, Mepilex Lite (MV Bamford and Company Ltd, Lower Hutt, New Zealand and Mölnlycke Health Care Gothenburg, Sweden) is currently used in New Zealand for the treatment of burns and slow-healing wounds.…”

Comparison between TEWL and laser scanning microscopy measurements for the in vivo characterization of the human epidermal barrier

“…Also, medical treatments, like radiotherapy for cancer, can lead to dysfunction of the epidermal barrier and subsequently to dry skin [5][6][7]. Different skin care products are commercially available, which intend to improve the skin parameters after radiotherapy for cancer [8][9][10][11].…”