Pérez, Y. L., Medina, J. A., Perez, I. L., & Garcia, C. M. (2011). Prevention and treatment of radiodermatitis using a non-adhesive foam dressing. Journal of Wound Care, 20, 130–135.

To measure healing (defined as complete re-epithelialization of the wound) and injury progression during radiation therapy (RT).

Data were collected daily from the onset of wet dermatitis until its resolution.

All patients received routine care, as described in the departmental protocol for the treatment of radiodermatitis.

The agent used was Mepilex Lite—a nonadhesive, thin, absorbent foam dressing with a soft silicone layer and film backing.

Participants were examined weekly based on Radiation Therapy Oncology Group (RTOG) Assessment Criteria 0 to 4

• Level 1 or 2 radiodermatitis:  topical chamomile or low-dose corticosteroid cream, twice daily
• Level 2 or 3 radiodermatitis with loss of tissue integrity and moist/wet desquamation:  daily cleansing with low dose (10%) chlorhexidine, antibacterial creams, and application of test dressing.

At onset of moist/wet desquamation, daily records were kept regarding the progression of lesions with photographs and a pain assessment until full healing was achieved.

• The sample was comprised of 20 consecutive patients (60% male, 40% female) with specified diagnoses.
• Mean age was 50.6 years (range 18–81).    
• Of the patients, eight had breast; four had ear, nose, and throat (ENT); two had rectum; three had sarcomas; and three had lung/chest cancer.
• Patients were excluded if they had (1) any tumor other than breast, ENT, lung, cervix, and sarcoma; (2) stopped treatment; or (3) died during treatment.
• Patients were undergoing RT for sarcomas, ENT, breast, cervix, and lung cancers (high risk of skin toxicity). Informed verbal consent was obtained.

• Single site
• Radiation oncology department  
• Malaga, Spain

• Patients were undergoing the active treatment phase of care.
• The study has clinical applicability for late effects and survivorship.

This was an observational study with no blinding.

• RTOG radiodermatitis assessment scale used to assess the grade of radiodermatitis
• Daily photographs through full healing

All wounds (20/20) progressed to full healing.

No infections occurred.

Mean total healing time was 9.5 days (range 3–22 days).

Patient rating of experience (scale from 1 to 10, with 1 being the worst and 10 being the best)

• Atraumatic dressing:  10
• Convenience:  9
• Patient’s aesthetic perception:  9
• Ease of use for health professionals/family:  10
• Adaptability:  9
• Length of time adhesive held:  7

Positive clinical and patient-centered outcomes were observed.

• The study had potential for bias in results because it was noncomparative in design, with no randomization or controls.
• The study had a small sample size, with less than 20 patients. 
• Confounding variables of chlorhexidine and application of antibiotic creams were not addressed; which variable was responsible for healing?

Although the observational study showed efficacy and safety in a small number of patients, further studies need to be developed that include blinding, randomization, controls, and potential for multicenter involvement.

Moist wound healing has been shown in numerous studies to be beneficial for healing, although there have been conflicting results with the use of hydrocolloidal dressings. Consideration as to cost-effectiveness and patient ability to access dressings without significant out-of-pocket costs must be determined.