the production of a best practice statement in the skincare of patients receiving radiotherapy

Abstract

Radiotherapy skin care is a contentious issue surrounded by myth, damaging and frightening stories and unfounded guidance. This is compounded by the fact that, when seeking information, patients, relatives and staff are faced with a barrage of conflicting, poorly researched data. Each of the five Scottish cancer centres worked together to produce guidance for all health professionals who are involved in the care of patients with radiotherapy skin reactions. As a result, a "Best Practice Statement" has been produced to give an overall view of radiotherapy skin reactions and their recommended care. This will guide best practice and dispel the many myths of care, which are still in existence, thus ensuring that equity of best practice care is available to all patients.

Are improvements needed in the management of severe acute skin reactions following completion of breast radiotherapy? A discussion of some possible service options

“…6 . 14 It is important that all health-care professionals who are responsible for providing ongoing skincare, including those in the community setting, have access to current evidenced-based guidelines. 1,4,10 It is important to have strategies in place for prevention and management of skin reactions.…”

A technique to reduce skin toxicity in radiotherapy treatment planning for esophageal cancer

“…This skin reaction usually begins with the dose of 20–25 Gy, and radiation dermatitis occurs significantly after the cumulative dose to the skin reaches 40 Gy in the middle and late stages of radiotherapy . The mild symptoms include local erythema, dryness, and desquamation, and the severe symptoms will be local skin pain, edema and exudates, moist desquamation and so on . Radiation‐induced skin reactions occur as a result of damage to the basal cell layer of the skin and resulting in an imbalance between the normal production of cells in this layer and the destruction of cells at the skin surface .…”

“…10 The mild symptoms include local erythema, dryness, and desquamation, and the severe symptoms will be local skin pain, edema and exudates, moist desquamation and so on. [11][12][13][14][15] Radiationinduced skin reactions occur as a result of damage to the basal cell layer of the skin and resulting in an imbalance between the normal production of cells in this layer and the destruction of cells at the skin surface. [16][17][18] Although skin toxicity is inevitable in the process of radiotherapy, the dose to skin can be reduced as much as possible through ideal treatment planning, so as to reduce the degree of skin injury during radiotherapy.…”

Mild soaps and radiotherapy: a survey of the UK public to identify brands of soap considered mild and analysis of these to ascertain suitability for recommendation in radiotherapy departments

“…Other anecdotal evidence suggests that recommendations differ greatly. However, in Scotland in 2004 a best practice statement was developed for use across the five Scottish centres to 'promote a consistent and cohesive approach to radiotherapy skin care' (Hornsby et al 2005). Clatterbridge Centre for Oncology NHS Foundation Trust (2009) suggests the use of baby soap and The Christie Patient Information Service (2008) recommends Simple or baby soap.…”

“…This compounded evidence from a previous survey by Lavery in 1995 which showed considerable variety in practice between radiotherapy centres. However, in Scotland in 2004 a best practice statement was developed for use across the five Scottish centres to 'promote a consistent and cohesive approach to radiotherapy skin care' (Hornsby et al 2005). This problem in variability of skin care advice is not limited to the UK.…”