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Mangili, G., Petrone, M., Gentile, C., De Marzi, P., Vigano, R., & Rabaiotti, E. (2008). Prevention strategies in palmar-plantar erythrodysesthesia onset: The role of regional cooling. Gynecologic Oncology, 108, 332–335.

Study Purpose

To evaluate the effectiveness of strategies to prevent ​palmar-plantar erythrodysesthesia (PPE) incidence, including regional cooling, behavioral rules, and lower-dose pegylated liposomal doxorubicin (PLD), in patients with gynecologic malignancies.

Intervention Characteristics/Basic Study Process

PLD doses ranged from 30 to 50 mg/m2 every 21 to 28 days. All patients received premedication with oral dexamethasone 8 mg (12 hours before PLD) and pyridoxine 300 mg PO daily. All patients were advised to follow strict behavioral rules: keep skin well hydrated, avoid sunlight, minimize trauma to the hands and feet, avoid contact with warm water, and avoid hot foods and liquids. Patients who were enrolled from 2001 to December 2003 were in the non–regional cooling group (n = 25), whereas patients who were enrolled from January 2004 to 2006 were in the regional cooling group (n = 28). Patients received regional cooling (application of ice packs around wrists and ankles) and icicles during PLD infusion.

Sample Characteristics

  • The study reported on a sample of patients who received PLD as a single therapy (n = 33), PLD plus carboplatin (n = 17), or PLD plus paclitaxel (n = 3).
  • All patients were women with gynecologic cancers (N = 53).

Setting

Obstetrical/Gynecological Department at San Raffaele Hospital in Milan, Italy

Study Design

This was a prospective, observational, single-center, nonrandomized study.

Measurement Instruments/Methods

Skin toxicity was graded according to National Cancer Institute (NCI) and Gynecologic Oncology Group (GOG) criteria.

Results

The incidence of PPE was significantly higher in the non–regional cooling group (n = 9, 36%) compared to the regional cooling group (n = 2, 7%; p = 0.0097).

Conclusions

Multivariant analysis revealed the use of a regional cooling protocol and lower PLD dosage were significant factors in reducing the onset and incidence of PPE. The authors estimated the probability of developing PPE in a patient who receives 30 to 35 mg/m2 of PLD and follows the regional cooling protocol is 1.42%. Conversely, a patient who does not adapt this regional cooling protocol and receives 40 to 50 mg/m2 of PLD every three weeks has a 60.41% estimated probability of developing PPE.

Limitations

  • The sample size was small.
  • This was a prospective, observational, nonrandomized study. Efficacy needs to be proven in a controlled and randomized study.
  • A combination of interventions was used in this study. All patients were given oral dexamethasone and oral pyridoxine as premedication. Therefore, determining the effectiveness of the individual interventions is difficult.
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Mandhaniya, S., Swaroop, C., Thulkar, S., Vishnubhatla, S., Kabra, S.K., Xess, I., & Bakhshi, S. (2011). Oral voriconazole versus intravenous low dose amphotericin B for primary antifungal prophylaxis in pediatric acute leukemia induction: A prospective, randomized, clinical study. Journal of Pediatric Hematology/Oncology, 33, e333–e341.

Study Purpose

The purpose of the study was to compare the efficacy and toxicity of oral voriconazole to IV low-dose amphotericin B in pediatric patients with acute leukemia.   

Intervention Characteristics/Basic Study Process

Oral variconazole was administered at a dose of 6 mg/kg per dose for initial two doses followed by 4 mg/kg per dose twice daily one hour before meals. Low-dose IV amphotericin B was administered at a dose of 0.5 mg/kg per day three times a week. Before administration of amphotericin B all patients received diphehydramine IV and oral paracetamol as premedication and saline hydration post infusion. Systemic antifungals were not allowed for use before patients underwent the trial. Complete blood count, liver function tests, and renal function tests were done at least twice weekly until seven days after completion or failure.

Sample Characteristics

  • The sample consisted of 100 patients aged 15 years or younger. 
  • Males were 75% of the sample, females were 25%
  • Key disease characteristics included acute myeloid and acute lymphoblastic leukemias.
  • Before induction chemotherapy, patients were eligible if they had no pneumonia on chest radiograph and no systemic antifungal therapy within seven days of randomization. Febrile patients who were hemodynamicaly stable with a normal chest radiograph also were included in the study.

Setting

  • Single site
  • Inpatient
  • New Dehli, India
     

Phase of Care and Clinical Applications

  • The phase of care was active treatment
  • The application was pediatrics.
     

Study Design

Randomized, non-stratified, open-label, single-institution pilot study.

Measurement Instruments/Methods

  • EORTC/MSG criteria for definition and classification of proven, probable, and possible invasive fungal infection.    
  • Hepatic toxicity was defined as liver function test values greater than 5 times the upper limit of normal.
  • Renal toxicity is defined as creatinine greater than 2 mg/dl.
     

Results

The overall probable, proven, and possible fungal infections were 5% in the study.  In the voriconazole arm, 28% had failure of prophylaxis compared to 34% failure rate in the amphotericin B arm. No differences were noted between groups in proven, probable, and possible fungal infections. Those receiving the voriconazole had significantly less toxicity, with 6% of patients in variconazole arm having any serious adverse event (SAE)  compared to 31% in the amphotericin B arm (hypokalemia) (p < 0.001). With the amphotericin B arm, 50% had infusion reactions.

Conclusions

 Oral voriconazole seemed to be comparable with amphotericin B, with less toxicity and more convenience.

Limitations

  • The empirical dose of varicanozole is an extrapolation of adult dose.
  • The authors did not perform pharmacokinetics of the patients to show whether the empirical dose of variconazole administered was efficacious or not.
  • There was no blinding in the study, with inherent risk of bias.

Nursing Implications

Potential increased need for patient and caregiver education regarding oral medication administration. Continued research in comparable efficacy of antifungal agents will be helpful in order to select effective agents that are least toxic, practical, and cost effective.

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Mancuso, A., Migliorino, M., De Santis, S., Saponiero, A., & De Marinis, F. (2006). Correlation between anemia and functional/cognitive capacity in elderly lung cancer patients treated with chemotherapy. Annals of Oncology, 17, 146–150.

Study Purpose

To investigate whether any association exists between hemoglobin (Hgb) levels and functional capacity, cognitive impairment, and comorbidities in older adult patients with lung cancer who were treated with chemotherapy

Intervention Characteristics/Basic Study Process

Patients were evaluated prior to the initiation of chemotherapy (baseline) and before each subsequent cycle (after 21 days) for quality of life, mental capacity, functional status, depression, and comorbidities.

Sample Characteristics

  • The study reported on a sample of 42 patients with a median age of 76.6 years (± 4.8 years).
  • Participants were 73.8% male and 26.2% female.
  • The patients were included if they were more than 70 years old and had a confirmed diagnosis of lung cancer for which they were undergoing chemotherapy. 
  • Patients were excluded if they had symptomatic brain metastases, preexisting major neurologic or psychiatric problems, or a history of substance abuse.

Setting

  • Single site
  • Rome, Italy

Study Design

A descriptive prospective study design was used.

Measurement Instruments/Methods

  • MMSE—global cognitive function
  • Comprehensive Geriatric Assessment (CGA)—a multidimensional, interdisciplinary diagnostic process to determine the medical, psychological, and functional capabilities of a frail older person. Includes
    • Activities of Daily Living (ADL)—scores ranging between 0–8 were used to assess functional status for self-care activities.
    • Instrumental Activities of Daily Living (IADL)—scores ranging between 0–8 were used to assess functional status for higher level activities.
    • Geriatric Depression Scale (GDS)—15-item questionnaire
    • Mini Nutritional Assessment (MNA)
  • Cumulative Illness Rating Scale-Geriatric (CIRS-G)—assesses the number and severity of comorbid conditions
  • Quality of life (QOL)/fatigue outcomes were measured by a visual analogue scale (VAS)

Results

Hgb level was significantly correlated with cognitive function at baseline prior to chemotherapy (r = 0.61, p < 0.002), as well as after one (r = 0.48, p < 0.002) and two cycles (r = 0.60, p < 0.002) of chemotherapy. A significant association was discovered between the change in Hgb levels and cognitive capacity as defined by the MMSE after the first (r = 0.48, p < 0.002) and second cycle (r = 0.60, p < 0.002) of chemotherapy. Significant associations were found between Hgb levels and VAS, CIRS-G, ADL, IADL assessments, and GDS at baseline and GDS at baseline and after one and two cycles of chemotherapy (p < 0.05). The strength of these correlations varied. Change in Hgb level was associated with the change in all above parameters with the exception of IADL, which was not significant.

Conclusions

Although the study was not designed to demonstrate a clinical benefit of erythropoietin on cognitive function during treatment, the authors noted that 14 patients who received erythropoietin during the first two cycles of chemotherapy experienced increases in the Hgb level and CGA indexes whereas patients who did not receive erythropoietin had a lowering of the Hgb levels and worsening of their CGA scores.

Limitations

  • The study had a small sample size for multiple chemotherapy regimens and variability in stage of disease.
  • The study included patients with brain metastases as long as they were not “symptomatic.” 
  • The study was not designed to specifically evaluate the effect of erythropoietin on cognitive function in patients with cancer.
  • MMSE is not sensitive enough to detect subtle cognitive changes.
  • There was a lack of alternate forms for repeated administration of MMSE.
  • Other factors such as performance status, chemotherapy regimen, and response to chemotherapy may have interacted with Hgb level and other examined variables.
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Mañas, A., Ciria, J.P., Fernández, M.C., Gonzálvez, M.L., Morillo, V., Pérez, M., . . . López-Gómez, V. (2011). Post hoc analysis of pregabalin vs. non-pregabalin treatment in patients with cancer-related neuropathic pain: Better pain relief, sleep and physical health. Clinical and Translational Oncology, 13, 656–663.

Study Purpose

To assess whether the use of pregabalin in combined therapy provides better health outcomes in patients with cancer-related neuropathic pain

Intervention Characteristics/Basic Study Process

This study was a post hoc analysis of data from a previous epidemiologic study of clinical prevalence and analgesic management of neuropathic pain. Patients who received pregabalin versus those who did not were compared. Analgesic management was done at the individual physician’s discretion. Patients had a baseline visit and a final visit at eight weeks. In the initial study, patients were not randomized to different treatment, and numerous other interventions for analgesia were done.

Sample Characteristics

  • The study reported on a sample of 273 patients.
  • Mean patient age was 62 years.
  • The sample was 55.6% male and 44.4% female.
  • Breast, lung, and genitourinary cancers were most prevalent.
  • All patients were receiving radiation therapy.

Setting

  • Multisite
  • Outpatient setting
  • Spain

Phase of Care and Clinical Applications

Patients were undergoing active antitumor treatment.

Study Design

The study was a post hoc analysis of data from a previous epidemiologic study.

Measurement Instruments/Methods

  • Brief Pain Inventory
  • Hospital Anxiety and Depression Scale
  • Medical Outcomes Sleep Scale
  • Short-Form Health Survey (SF-12)

Results

The most frequent cause of neuropathic pain was the tumor itself, and cisplatin was the most frequently used chemotherapeutic agent. Fentanyl patches were used more frequently in the pregabalin group. Pain intensity improved in all patients at eight weeks, but improved more with pregabalin (change = 0, 9 points, p = 0.0084). Depression and anxiety decreased significantly in both groups. Physical component and mental component scores on the SF-12 improved in all patients, but improved more in those on pregabalin. When data were adjusted for age and sex, differences from baseline scores were less than 1. There were significant differences in groups in other medications used, numbers of analgesic interventions, and amount of radiation therapy treatment.

Conclusions

It is difficult to draw any firm conclusions regarding efficacy of pregabalin from this study due to the differences in multiple other variables between study groups that could also affect the outcome measures used here. Changes from baseline measures seen at eight weeks were significant, but very small, raising the question of the clinical significance of results.

Limitations

  • The study had baseline sample/group differences of import.
  • The study had risk of bias due to no control group, no blinding, no random assignment, and sample characteristics.
  • There were substantial differences in treatments used, as well as disease factors between groups compared here.

Nursing Implications

No firm conclusions can be drawn from these results due to study limitations. Findings aim to show that use of pregabalin for neuropathic pain improves symptoms and  health outcomes. Differences from baseline reported here were small, suggesting lack of meaningful differences from a clinical perspective. Results point to the need for nurses to recognize the difference between statistical and clinical significance in evaluating intervention effects.

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Maltoni, M., Scarpi, E., Modonesi, C., Passardi, A., Calpona, S., Turriziani, A., . . . Amadori, D. (2005). A validation study of the WHO analgesic ladder: A two-step vs. three-step strategy. Supportive Care in Cancer, 13, 888–894.

Study Purpose

To determine if, on the WHO analgesic ladder, passing directly from step 1 to step 3 is more effective than the traditional three-step strategy for treating chronic cancer pain; to evaluate the tolerability and therapeutic index of both strategies

Intervention Characteristics/Basic Study Process

Over 24 months, patients were monitored at home by telephone or a home health nurse. The study design included two arms: in one, patients moved from step 1 to step 3 (with treatment with strong opioids); in the other, patients moved from step 1, to step 2 (with treatment with weak opioids), to step 3.

Sample Characteristics

  • The sample was composed of 54 patients.
  • Patients were age 18 and older.
  • The sample was composed of patients with multiple visceral or bone metastases or locally advanced disease.

Setting

Italy

Study Design

Randomized controlled trial

Measurement Instruments/Methods

  • Numeric Rating Scale (NRS), 0–10, to measure pain
  • Five-step scale, 0–4, to measure other symptoms
  • Five-step scale, 0–4, to measure degree of patient satisfaction
  • Use of coanalgesics, adjuvants, and other treatments (as established by a yes/no answer)

Results

  • Going from step 1 to step 3 resulted in a statistically significant advantage over the traditional progression. Authors did not report the P value.
  • Authors noted that all patients needed prophylactic treatment of constipation.

Conclusions

Preliminary data suggest that a direct move to the third step is feasible and could reduce some pain scores. The two-step strategy this study supports requires careful management of side effects.

Limitations

The study had a small sample size.

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Maltoni, M., Nanni, O., Scarpi, E., Rossi, D., Serra, P., & Amadori, D. (2001). High-dose progestins for the treatment of cancer anorexia-cachexia syndrome: A systematic review of randomised clinical trials. Annals of Oncology, 12, 289–300.

Purpose

To review the prospective randomized clinical trials (RCTs) that evaluate the use of progestins in cancer anorexia-cachexia syndrome compared with placebo in patients with hormone-independent tumors

Search Strategy

Databases searched were MEDLINE, CANCERLIT, Embase, and CINAHL, in addition to hand searching of reference lists.

Literature Evaluated

Of the 38 studies identified, 15 RCTs, published between July 1990 and June 1999, met inclusion criteria. The studies selected used various drug dosages, durations of treatment, eligibility criteria, population types, study designs, methods of assessment, methods of reporting results, and outcomes.

Sample Characteristics

The review reported on 2,102 patients, compiled from six studies of 557 patients that received neither chemotherapy nor radiation, and nine studies of 1,545 patients that received some form of concomitant therapy.

Results

Among the several outcomes analyzed, effect on body weight was assessed in all studies, and only two studies did not evaluate the effect on appetite. The most frequent method of assessing appetite was the visual analog scale.

Conclusions

There was a significant advantage for the use of high-dose progestins regarding improved appetite and body weight gain to support the safety and feasibility of treatment with oral progestins.

Limitations

Most of the studies were short in duration, lasting from 1 to 12 weeks.

Nursing Implications

Important issues, such as dosage, duration of treatment, best time to start treatment, and eventual impact on overall improved quality of life, have yet to be defined.

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Malicka, I., Stefańska, M., Rudziak, M., Jarmoluk, P., Pawłowska, K., Szczepańska-Gieracha, J., & Woźniewski, M. (2011). The influence of Nordic walking exercise on upper extremity strength and the volume of lymphoedema in women following breast cancer treatment. Isokinetics and Exercise Science, 19(4), 295–304.

Study Purpose

To examine the effect of Nordic walking on upper-extremity strength and lymphedema

Intervention Characteristics/Basic Study Process

Participants were randomly assigned to the walking group or the control group, who did not participate in any rehabilitation program. The program consisted of two hour-long sessions each week for eight weeks. Sessions involved a 10-minute warm up and 40 minutes of Nordic walking at 85% of maximum heart rate, followed by 10 minutes of stretching and relaxation exercises.

Sample Characteristics

  • The study sample was all female with a mean age of 62.8 years.
  • Patients had undergone radical mastectomy (79%) or breast-conserving surgery (21%). Mean time since surgical treatment was 7.6 years.
  • Most patients had received adjuvant therapy, chemotherapy, radiation therapy, or hormonal therapy.
  • No axillary dissection was reported.
  • Only 34% of patients had lymphedema.

Setting

The study took place in an outpatient setting in Poland.

Phase of Care and Clinical Applications

  • Patients were undergoing long-term follow-up care.
  • The study has clinical applicability for late effects and survivorship.

Study Design

The study used a randomized controlled trial design.

Measurement Instruments/Methods

  • An isokinetic dynamometer was used to test muscle strength.
  • Lymphedema volume was evaluated by measuring circumferences of both upper extremities with use of a tape measure at five levels.

Results

A variety of changes in muscle strength were observed. No differences were found between groups in arm volume results.

Conclusions

The study did not provide any evidence that Nordic walking improved lymphedema.

Limitations

  • The sample size was small, with fewer than 100 patients.
  • The authors did not indicate if exercise was done alone or in groups. 
  • Only a third of patients had lymphedema.
  • High variability existed in the sample of time since surgery, which would be expected to influence observance of lymphedema. 
  • No other lymphedema risk factors were reported, and use of other prevention or treatment strategies were not discussed.
  • The study was not blinded.

Nursing Implications

The study had several methodologic weaknesses and did not provide strong evidence either for or against the effects of Nordic walking on lymphedema after breast cancer treatment.

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Maldonado, G.E., Perez, C.A., Covarrubias, E.E., Cabriales, S.A., Leyva, L.A., Perez, J.C., & Almaguer, D.G. (2011). Autologous stem cells for the treatment of post-mastectomy lymphedema: A pilot study. Cytotherapy, 13(10), 1249–1255.

Study Purpose

To establish the efficacy of using autologous stem cells (ASC) for the treatment of lymphedema associated with axillary lymph node dissection, define the possible complications, and compare outcomes with compression sleeve therapy

Intervention Characteristics/Basic Study Process

Twenty patients were randomly assigned to the ASC group or the control group. The ASC group received subcutaneously administered granulocyte-colony-stimulating factor (300 mg per day) for three days prior to the procedure. On procedure day, 100 ml bone marrow was harvested from east posterior iliac crest while the patient was under conscious sedation. The product was centrifuged and, under laminar flow hood, plasma was removed and transferred to sterile test tube. Cells were isolated, and CD34 cells were counted using a flow cytometer. A specimen for microbe and 0.5–1 ml of cell suspension containing 20% albumin and normal saline was administered by intramuscular injection at 30–50 sites of the affected limb, depth of 1 cm, with 25 g needle. Injection range included around the axillary and affected chest wall and part of the upper arm during the first four weeks. Use was discontinued for the following four weeks and then used again for another four weeks. Patients were not allowed to use any other modality of treatment for lymphedema, including manual lymph drainage, exercise drug therapy, or skin products. The control group was given a four-hour practice session on correct use of compression sleeve of 15–20 mmHg.

Sample Characteristics

  • The study sample (N = 20) was comprised of female patients with unilateral lymphedema secondary to mastectomy and axillary node dissection.
  • Mean age of participants was 50–56 years.
  • All patients had not had active cancer in the past five years.
  • Patients were excluded from the study if they were older than 75 years, had hypercoagulable states, cardiovascular disease, or bilateral mastectomies.

 

Setting

The study took place at the University Hospital of the School of Medicine of the Universidad Autonoma de Nuevo Leon in Mexico.

Phase of Care and Clinical Applications

The study has clinical applicability for late effects and survivorship.

Study Design

The pilot study randomly assigned 10 women to either the ASC group or control group.

Measurement Instruments/Methods

  • Patient's weight was recorded.
  • Limb volume measurements were taken of bilateral upper extremities in four areas, calculating mean by summation.
  • Arm volume was determined by trunked cone principle were obtained weekly for 12 weeks.
  • Patients were evaluated for pain, sensory loss, and arm mobility.

Results

After 12 weeks, the ASC group had decreased pain, improved sensitivity, and improved mobility as compared to the control group. Volume reductions were similar between the two groups, with the control group being more user dependent.

Conclusions

The study does not provide sufficient evidence to determine potential efficacy of stem cell transplant to manage lymphedema.

Limitations

  • The study had a small sample size, with less than 30 participants.
  • Sample characteristics present a risk of bias.
  • Measurement validity and reliability is questionable.
  • The findings are not generalizable.
  • The intervention is expensive, impractical, or requires training.

Nursing Implications

It is important to be aware of studies being conducted. The study has limited practical value in the United States today, but as ASC becomes a more accepted and standard of care, awareness of the decreases in pain and increased sensitivity and mobility may be of benefit.

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Mak, S.S., Zee, C.Y., Molassiotis, A., Chan, S.J., Leung, S.F., Mo, K.F., & Johnson, P.J. (2005). A comparison of wound treatments in nasopharyngeal cancer patients receiving radiation therapy. Cancer Nursing, 28, 436–445.

Study Purpose

To compare the effectiveness of gentian violet (GV) and non-adherent absorbent dressing in the healing of moist desquamation

Intervention Characteristics/Basic Study Process

The study group were patients with moist desquamation after irradiation. Wounds were cleansed with 0.9% saline at each visit after completion of the assessment by the nurse. Then a nonadherent dressing was applied and secured with tape. Patients applied the dressing on days they were not seen by the nurse. The control group were patients taught to make homemade salted water, who rinsed the wound and then applied GV. Wound culture was taken at the entry of the study and as needed based on signs of infection.

Sample Characteristics

  • The study sample (N = 142) was comprised of male (87%) and female (13%) patients with head and neck cancers who were assigned to the study group (n = 73) or the control group (n = 69).
  • Mean age was 54.09 years (SD = 13.9 years) in the study group and 53.07 years (SD = 11.31 years) in the control group.

Setting

The study took place at Prince of Wales Hospital at the Chinese University of Hong Kong.

Study Design

The study used a randomized controlled trial open label design.

Measurement Instruments/Methods

  • Wound healing, healing time, and presence of infection were assessed through erythema, increased drainage, purulent drainage, increase tenderness, and fever and leukocytosis,
  • Wound pain was measured on a 0–5 scale.
  • Affect of mood changes, restriction of neck movement, social isolation, sleep problems, and disturbance in body image were also reported.

Results

No significant differences were found between groups regarding wound healing, healing time, impact of mood changes, social isolation, sleep problems, disturbance in body image, or restriction of neck movement. Initial wound size was greater than 10 cm2. Higher dose of radiation and overall stage were an independent determinant of prolonged time to wound healing. The dressing was not a factor. 

Conclusions

The study did not support the use of hydrogel dressings in the care of patients with moist desquamation.

Limitations

  • Patient compliance in self-care was not assessed.
  • Large range in dose administration of the radiation therapy, which would be expected to influence results.
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Mak, S.S., Molassiotis, A., Wan, W.-M., Lee, I.Y.M., & Chan, E.S.J. (2000). The effects of hydrocolloid dressing and gentian violet on radiation-induced moist desquamation wound healing. Cancer Nursing, 23, 220–229.

Study Purpose

To examine effectiveness of hydrocolloid dressing in the management of moist desquamation after radiation therapy is complete

Intervention Characteristics/Basic Study Process

Patients with moist desquamation were randomly assigned to one of two arms: hydrocolloid dressing (experimental group) or gentian violet (GV) (control group). Chemotherapy was used in stratifying patients for subgroup analysis.

Sample Characteristics

  • The study sample (N = 39) was comprised of male (n = 22) and female (n = 17) patients with neck, chest, axilla, or perineal area cancer.
  • Mean age was 52.06 years for the hydrogel group (SD = 11.56 years) and 51.07 years for the GV group (SD = 10.41 years).
  • Of patients in the sample, 30% also received chemotherapy.

Setting

The study took place at a hospital authority of Hong Kong.

Study Design

The study used a randomized controlled trial design.

Measurement Instruments/Methods

  • Sites were documented initially and monitored using a tracing method for moist desquamation wounds.
  • Healing time was indicated in days before skin integrity returned (re-epithelialization with absence of moist desquamation and burning).
  • The wound area was traced on alternating days.
  • Incidence of infection assessed erythema and edema, increased drainage, change in drainage, increase tenderness, fever, or leukocytosis.
  • Pain was evaluated using a frequency scale of 1–3 intensity with Wong Baker faces.

Results

  • Chemotherapy showed worse effect on wound healing that was statistically significant (f = 4.4, p < 0.01)
  • Wound size in assessments was smaller in the GV arm and trend of healing seen from second visit onward.
  • Pain level was higher in hydrocolloid group.
  • There was no statistically significant difference in wound healing time between groups.
  • Wound size decreased quicker in the GV group.
  • Patients had a higher satisfaction with hydrocolloid dressing for appearance and comfort.

 

Conclusions

GV was more effective in healing of moist desquamation but hydrocolloid was more comforting and pleasing.

Limitations

  • The study had a small sample size, with less than 50 participants.
  • The experimental group had a larger percentage with use of chemotherapy in addition to radiation, and some patients with comorbid conditions that could have affected healing
  • Assessment of the GV group relied on self-report.
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