radiation burn

[bebop1]

I have just admitted a patient into home health for a radiation burn that takes her whole neck...I mean her whole neck..front, back sides.....its horrible. when I walked into her home...I think I gasped. I have been in home health for a while, and this is the worst wound I have ever seen, I have seen some. some so bad that "legs almost fall off when I would pick them up". This burn is red/green/scales/dry/wet/swollen/cracked/draining/bleeding. it just depends where you look. at first the doctor had her use biafine. and it was working a little...then is wasn't. so he prescribed a steroid cream. That just about killed her. and tore her neck up. she is now in this state. he had her go to the pharmacy and order Vigilon it won't come in until tomorrow? I have never used this? but then gave an order for us today. I am lost. I have no idea what to do for her. when I looked up this stuff it looks like a 'cool' hydrogel. will this work? should we try it? or is there any other suggestions. I really am lost. I have never seen anything like this. I got her some antibiotics, and pain medications. told her to cont the biafine tonight, and then we will try this vigilon tomorrow when it comes in, or if I find anything else we can use? anything else out there I should do instead? she is done with the radiation. thank goodness.

any suggestions....would be wonderful.....Thanks!

[oldiebutgoodie, RN]

In terms of a dressing, our cancer center has been using Mepilex Lite, which is a thin adhesive silicone foam. It sticks to the burn, but doesn't hurt coming off. It can be lifted off, medication applied, and put back down.

http://www.molnlycke.us/item.asp?id=15137&pid=23560&lang=2&si=181

http://www.tendra.com/Files/Tendra/Product%20sheets/New/mepilex_lite_productsheet.pdf

It's also pretty expensive, maybe insurance can cover it.

Oldiebutgoodie

[bebop1]

just an update....

pts wound looks wonderful. we used the vigilon once, she stated it burned so much she couldn't stand it.

she loved the biafine, so we pretty much have just went daily to give her one good cleaning because she was not cleaning it good, and then helping rub in the biafine good because she was not doing that either. and happy to say she is no longer needing daily wound care!