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Abstract:
Purpose: There are no specific practice guidelines for the treatment of radiation dermatitis, only recommendations for topical skin agents with varying degrees of evidence of success. The objective of this case study is to report an effective therapy for acute moist desquamation radiation dermatitis.
Clinical Problem: A 66-year-old female, former smoker, underwent radiation and chemotherapy for left piriform sinus squamous cell carcinoma. Two months later, she had developed severe moist desquamation of the entire neck circumference. She also developed mucositis, had a 36 lb. weight loss and dehydration, requiring PEG tube placement. Home health care was ordered for wound care after discharge from the hospital. The silvadene and xeroform gauze applied in the hospital prior to discharge were adhered, causing significant pain and restricting neck movement.
Clinical Approach: Based on some of the literature and case studies reviewed, the wound consultant developed a plan of care. It took 2 visits for the nurse to remove the adhered dressings with Skintegrity spray wound cleanser to saturate the dressings and remove them without causing the patient further trauma, bleeding, and pain. Then Biafine (which also has non-steroidal anti inflammatory properties) was applied and covered with Mepilex Lite daily. Case consultation via phone and e-mailed photography between the home health nurse and wound consultant was done at least weekly to monitor progress.
Patient Outcomes: Patient reported instant pain relief once Biafine and Mepilex Lite were applied. After two weeks, there was no need to cover the area with Mepilex Lite and only Biafine was applied daily after showering. She experienced rapid healing. All the radiation dermatitis was completely healed in 4 weeks, with no adverse events and improved quality of life.
Conclusion: This case study shows the effectiveness of a treatment for acute severe moist desquamation radiation dermatitis with Biafine and Mepilex Lite.
Purpose: There are no specific practice guidelines for the treatment of radiation dermatitis, only recommendations for topical skin agents with varying degrees of evidence of success. The objective of this case study is to report an effective therapy for acute moist desquamation radiation dermatitis.
Clinical Problem: A 66-year-old female, former smoker, underwent radiation and chemotherapy for left piriform sinus squamous cell carcinoma. Two months later, she had developed severe moist desquamation of the entire neck circumference. She also developed mucositis, had a 36 lb. weight loss and dehydration, requiring PEG tube placement. Home health care was ordered for wound care after discharge from the hospital. The silvadene and xeroform gauze applied in the hospital prior to discharge were adhered, causing significant pain and restricting neck movement.
Clinical Approach: Based on some of the literature and case studies reviewed, the wound consultant developed a plan of care. It took 2 visits for the nurse to remove the adhered dressings with Skintegrity spray wound cleanser to saturate the dressings and remove them without causing the patient further trauma, bleeding, and pain. Then Biafine (which also has non-steroidal anti inflammatory properties) was applied and covered with Mepilex Lite daily. Case consultation via phone and e-mailed photography between the home health nurse and wound consultant was done at least weekly to monitor progress.
Patient Outcomes: Patient reported instant pain relief once Biafine and Mepilex Lite were applied. After two weeks, there was no need to cover the area with Mepilex Lite and only Biafine was applied daily after showering. She experienced rapid healing. All the radiation dermatitis was completely healed in 4 weeks, with no adverse events and improved quality of life.
Conclusion: This case study shows the effectiveness of a treatment for acute severe moist desquamation radiation dermatitis with Biafine and Mepilex Lite.