Skin care for radiation therapy patients
Dear OncoLink "Ask The Experts,"
Is it always necessary to remove the dressing on a radiodermitis wound during radiation therapy? What kind of products can be used during therapy and which products and dressings cannot be used?
Ruth Collins, MSN, CRNP, Research Nurse Coordinator Department of Radiation Oncology at the University of Pennsylvania, responds:, responds:
Wound care is extremely important if the skin becomes irritated from radiation therapy. Nurses at most radiation centers are experts in the treatment of irritated skin from radiation therapy (radiodermatitis). There are different degrees of irritation, so each patient is treated individually. Topical wound care starts with washing the area with a very mild soap. Dove® has been tested and is rated the mildest soap. Patients who are continuing treatment and develop an erythematous reaction (red, irritated skin) should use products that are absorbed by the skin such as hydrocactive gels. Most centers have sample products for the patient to test. At the University of Pennsylvania, we recommend that these products be applied at least 2 hours prior to radiation therapy to allow time to absorb so that it does not provide a bolus effect (which increases the dose of radiation delivered to the skin). Topical agents that are not absorbed should not be applied prior to treatment unless they are washed off completely with a mild soap.
Patients with a moist desquamation (wet, peeling skin) should use a protective dressing to the area, such as telfa® or Exu-dry® (an absorbent dressing). Also, hydrocolloid dressings such as Vigilon® and occlusive or moisture-vapor-permeable dressings may be applied. These types of dressings must be removed daily prior to the radiation treatment and reapplied post treatment.
Reference: Watkins-Bruner, D., Moore-Higgs, G. & Haas, M. Outcomes in Radiation Therapy: A Multidisciplinary Management (2001). Jones and Bartlett Publishers: Boston. pp. 504-505.