How Does Tumor Patient Nurse the Skin During Radiotherapy
Radiotherapy is one of the main methods to treat tumor with ionizing radiation. Due to the stimulation of radiation, the skin in the radiotherapy area will have different degrees of radioactive skin reaction, generally divided into Ⅰ, Ⅱ, Ⅲ, Ⅳ degrees. Different nursing measures should be taken according to different degrees of radiation reaction.
Ⅰ and Ⅱ degree skin reaction care
Generally, after 10 irradiations, the skin begins to dry, showing erythema, flushing, burning and itching (degree I), and eventually turns dark red and epidermis shedding called dry dermatitis (degree II). Patients generally do not stop radiation with Ⅰ and Ⅱ skin reaction. For patients with itchy skin, gently pat the itchy part of the skin, or apply borneol, talc powder, mint starch, prickly heat powder, which can not only relieve itching, but also make the local skin dry. But borneol, talc powder, etc. should not be used too much to avoid blocking the pores and causing folliculitis. Patients should not scratch with their hands, otherwise it will lead to skin ulceration, infection and long-term non-healing. Dry dermatitis can be topically coated with biafen 2-3 times to protect the skin of the radiotherapy field. Do not smear lotion, cream, VitC solution or moisturizing cream locally, so as not to aggravate the skin reaction in the radiotherapy area. Aloe Vera has anti-inflammatory effect, but it has no moisturizing effect. Some patients even have allergies to Aloe Vera. Therefore, it is not recommended for use during radiotherapy. Steroid ointment can reduce skin reaction after radiotherapy, but it is ineffective for itching and pain. It can also cause local burning so as to cover up infection, which affects wound healing. It should be used cautiously. Do not use vaseline, because it is difficult to remove, and in the treatment will increase the post-radiotherapy response.
Ⅲ degree skin reaction care
With the increase of the number of irradiation, local skin appears congestion, edema, blisters. In serious case, there is erosion and exudate. This is called wet dermatitis (degree III). At this time, radiotherapy should be stopped and symptomatic treatment should be carried out. For small blisters, they should not be punctured. If there is skin erosion, 1% gentian violet can be smeared locally 2 to 3 times a day. Do not use talcum powder, because it will block sweat glands and hair follicles to aggravate the reaction, and if the skin is damaged, the two will gather together to form a vector of bacterial infection. For large blisters, disinfect blisters immediately, and use a sterile syringe to extract the effusion. Apply sterile Vaseline gauze on wound surface, protect local skin, and retain effusion and epidermal tissue for bacterial culture and drug sensitivity test, so as to control infection with effective antibiotics as soon as possible. After blister absorption, exposed wound therapy can be used to keep the local skin clean and dry, and MEBO scald ointment is applied on the skin. After one week, the exudation is significantly reduced. After healing, radiotherapy could be continued.
Ⅳ degree skin reaction care
If the wet reaction can not be controlled in time, the local skin will develop further necrosis and peeling, ulcer formation (degree IV), showing grey-white necrotic tissue covering, clear boundary, smooth bottom, crater-shaped formation of subeschar ulcer, with severe pain. Radiotherapy should be discontinued at this time. And it can be continued only after symptomatic treatment and healing. Exposure therapy and topical anti-inflammatory ointments, such as erythromycin and chloramphenicol ointment, can be used; when the infection is serious, anti-inflammatory drugs can be intramuscularly injected or intravenously dripped. At the same time, keep the wound clean and dry to facilitate healing. When the ulcer area is large, skin grafting is needed.
Radiation dermatitis is a common side effect of radiotherapy. Through the joint efforts of medical staff, skin care in radiotherapy area should be strengthened to ensure the smooth progress of radiotherapy. For more information on tumor, please leave a message below or contact online doctor.
***Please seek professional medical advise for the diagnosis or treatment of any ailment, disease or medical condition. This article is not intended to be a substitute for the advice of a licensed medical professional.***