Multimedialna platforma wiedzy medycznej Internetowa Księgarnia Medyczna Kalendarium Konferencji
Nowotwory. Journal of Oncology
MENU
Shortcuts Submit an article Author Guidelines Ahead Of Print Editorial Office Manuscript Submission Reviewers 2023 Best Original Paper Award

open access

Vol 72, No 2 (2022)
Review paper
Published online: 2022-04-08
View PDF Download PDF file View HTML
Get Citation

How to manage radiation-induced dermatitis?

Dorota Kiprian1, Agata Szykut-Badaczewska2, Agnieszka Gradzińska2, Joanna Czuwara2, Lidia Rudnicka2
DOI: 10.5603/NJO.2022.0017
·
Nowotwory. Journal of Oncology 2022;72(2):86-95.
Affiliations
  1. Department of Head & Neck Cancer, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
  2. Department of Dermatology, Medical University of Warsaw, Warsaw, Poland

open access

Vol 72, No 2 (2022)
Review article
Published online: 2022-04-08

Abstract

Radiotherapy is one of the treatment methods available for cancer patients. More than half of all cancer patients tre­ated with radiotherapy will experience radiodermatitis during their treatment. There are two commonly used scales to evaluate clinical manifestations: Common Terminology Criteria for Adverse Events (CTCAE) and the Radiation Therapy Oncology Group (RTOG) scale. According to them, the severity of radiation dermatitis ranges from mild erythema to moist desquamation and ulceration. Prevention methods for radiation dermatitis include proper skin hygiene, the use of topical corticosteroids, other non-corticosteroid agents and systemic drugs. Treatment of radiation dermatitis is guided by the severity of skin damage. In grade 1 it can be limited to moisturising the irritated skin field but in more severe reactions (grade 2–4) the use of dressing is essential. There is still a need to investigate new products, techniques or novel approaches to minimize, prevent or treat radiation dermatitis in patients undergoing radiotherapy.

Abstract

Radiotherapy is one of the treatment methods available for cancer patients. More than half of all cancer patients tre­ated with radiotherapy will experience radiodermatitis during their treatment. There are two commonly used scales to evaluate clinical manifestations: Common Terminology Criteria for Adverse Events (CTCAE) and the Radiation Therapy Oncology Group (RTOG) scale. According to them, the severity of radiation dermatitis ranges from mild erythema to moist desquamation and ulceration. Prevention methods for radiation dermatitis include proper skin hygiene, the use of topical corticosteroids, other non-corticosteroid agents and systemic drugs. Treatment of radiation dermatitis is guided by the severity of skin damage. In grade 1 it can be limited to moisturising the irritated skin field but in more severe reactions (grade 2–4) the use of dressing is essential. There is still a need to investigate new products, techniques or novel approaches to minimize, prevent or treat radiation dermatitis in patients undergoing radiotherapy.

Full Text:

View PDF Download PDF file View HTML
Get Citation

Keywords

radiation dermatitis; radiodermatitis; acute skin toxicity; radiotherapy

About this article
Title

How to manage radiation-induced dermatitis?

Journal

Nowotwory. Journal of Oncology

Issue

Vol 72, No 2 (2022)

Article type

Review paper

Pages

86-95

Published online

2022-04-08

Page views

5546

Article views/downloads

1998

DOI

10.5603/NJO.2022.0017

Bibliographic record

Nowotwory. Journal of Oncology 2022;72(2):86-95.

Keywords

radiation dermatitis
radiodermatitis
acute skin toxicity
radiotherapy

Authors

Dorota Kiprian
Agata Szykut-Badaczewska
Agnieszka Gradzińska
Joanna Czuwara
Lidia Rudnicka

References (90)
  1. Seité S, Bensadoun RJ, Mazer JM. Prevention and treatment of acute and chronic radiodermatitis. Breast Cancer (Dove Med Press). 2017; 9: 551–557.
    CrossRefPubMed
  2. Hickok JT, Morrow GR, Roscoe JA, et al. Occurrence, severity, and longitudinal course of twelve common symptoms in 1129 consecutive patients during radiotherapy for cancer. J Pain Symptom Manage. 2005; 30(5): 433–442.
    CrossRefPubMed
  3. Hickok JT, Roscoe JA, Morrow GR, et al. Frequency, severity, clinical course, and correlates of fatigue in 372 patients during 5 weeks of radiotherapy for cancer. Cancer. 2005; 104(8): 1772–1778.
    CrossRefPubMed
  4. Huang HY, Wilkie DJ, Schubert MM, et al. Symptom profile of nasopharyngeal cancer patients during radiation therapy. Cancer Pract. 2000; 8(6): 274–281.
    CrossRefPubMed
  5. Rose-Ped AM, Bellm LA, Epstein JB, et al. Complications of radiation therapy for head and neck cancers. The patient's perspective. Cancer Nurs. 2002; 25(6): 461–7; quiz 468.
    CrossRefPubMed
  6. Primavera G, Carrera M, Berardesca E, et al. A double-blind, vehicle-controlled clinical study to evaluate the efficacy of MAS065D (XClair), a hyaluronic acid-based formulation, in the management of radiation-induced dermatitis. Cutan Ocul Toxicol. 2006; 25(3): 165–171.
    CrossRefPubMed
  7. Porock D. Factors influencing the severity of radiation skin and oral mucosal reactions: development of a conceptual framework. Eur J Cancer Care (Engl). 2002; 11(1): 33–43.
    PubMed
  8. Hymes SR, Strom EA, Fife C. Radiation dermatitis: clinical presentation, pathophysiology, and treatment 2006. J Am Acad Dermatol. 2006; 54(1): 28–46.
    CrossRefPubMed
  9. Bolderston A, Lloyd NS, Wong RKS, et al. Supportive Care Guidelines Group of Cancer Care Ontario Program in Evidence-Based Care. The prevention and management of acute skin reactions related to radiation therapy: a systematic review and practice guideline. Support Care Cancer. 2006; 14(8): 802–817.
    CrossRefPubMed
  10. Ryan JL. Ionizing radiation: the good, the bad, and the ugly. J Invest Dermatol. 2012; 132(3 Pt 2): 985–993.
    CrossRefPubMed
  11. Brown KR, Rzucidlo E. Acute and chronic radiation injury. J Vasc Surg. 2011; 53(1 Suppl): 15S–21S.
    CrossRefPubMed
  12. Vuong Té, Franco E, Lehnert S, et al. Silver leaf nylon dressing to prevent radiation dermatitis in patients undergoing chemotherapy and external beam radiotherapy to the perineum. Int J Radiat Oncol Biol Phys. 2004; 59(3): 809–814.
    CrossRefPubMed
  13. Wells M, Macmillan M, Raab G, et al. Does aqueous or sucralfate cream affect the severity of erythematous radiation skin reactions? A randomised controlled trial. Radiother Oncol. 2004; 73(2): 153–162.
    CrossRefPubMed
  14. Twardella D, Popanda O, Helmbold I, et al. Personal characteristics, therapy modalities and individual DNA repair capacity as predictive factors of acute skin toxicity in an unselected cohort of breast cancer patients receiving radiotherapy. Radiotherapy and Oncology. 2003; 69(2): 145–153.
    CrossRef
  15. Welsh J, Thomas J, Shah D, et al. Obesity increases the risk of chest wall pain from thoracic stereotactic body radiation therapy. Int J Radiat Oncol Biol Phys. 2011; 81(1): 91–96.
    CrossRefPubMed
  16. Delfino S, Brunetti B, Toto V, et al. Burn after breast reconstruction. Burns. 2008; 34(6): 873–877.
    CrossRefPubMed
  17. Ross JG, Hussey DH, Mayr NA, et al. Acute and late reactions to radiation therapy in patients with collagen vascular diseases. Cancer. 1993; 71(11): 3744–3752, doi: 10.1002/1097-0142(19930601)71:11<3744::aid-cncr2820711144>3.0.co;2-c.
    PubMed
  18. Tamminga RYJ, Dolsma WV, Leeuw JA, et al. Chemo- and radiosensitivity testing in a patient with ataxia telangiectasia and Hodgkin disease. Pediatr Hematol Oncol. 2002; 19(3): 163–171.
    CrossRefPubMed
  19. Dörr W. Skin and other reactions to radiotherapy--clinical presentation and radiobiology of skin reactions. Front Radiat Ther Oncol. 2006; 39: 96–101.
    CrossRefPubMed
  20. Fernando IN, Ford HT, Powles TJ, et al. Factors affecting acute skin toxicity in patients having breast irradiation after conservative surgery: a prospective study of treatment practice at the Royal Marsden Hospital. Clin Oncol (R Coll Radiol). 1996; 8(4): 226–233.
    CrossRefPubMed
  21. Tejwani A, Wu S, Jia Y, et al. Increased risk of high-grade dermatologic toxicities with radiation plus epidermal growth factor receptor inhibitor therapy. Cancer. 2009; 115(6): 1286–1299.
    CrossRefPubMed
  22. Poggi MM, Coleman CN, Mitchell JB, et al. Radiation and chemotherapy sensitizers and protectors. Crit Rev Oncol Hematol. 1990; 10(3): 225–252.
    CrossRefPubMed
  23. Warde P. Radiotherapy: practical applications and clinical aspects. Medicine. 2008; 36(1): 15–18.
    CrossRef
  24. Bergonie JTL. De quelques resultats de la radiotherapie et essai de fixation dune techique rationelle. Cr Acad Sci. 1906; 143: 983–985.
  25. Bray FN, Simmons BJ, Wolfson AH, et al. Acute and Chronic Cutaneous Reactions to Ionizing Radiation Therapy. Dermatol Ther (Heidelb). 2016; 6(2): 185–206.
    CrossRefPubMed
  26. Stone HB, Coleman CN, Anscher MS, et al. Effects of radiation on normal tissue: consequences and mechanisms. Lancet Oncol. 2003; 4(9): 529–536.
    CrossRefPubMed
  27. Müller K, Meineke V. Radiation-induced alterations in cytokine production by skin cells. Exp Hematol. 2007; 35(4 Suppl 1): 96–104.
    CrossRefPubMed
  28. Janko M, Ontiveros F, Fitzgerald TJ, et al. IL-1 generated subsequent to radiation-induced tissue injury contributes to the pathogenesis of radiodermatitis. Radiat Res. 2012; 178(3): 166–172.
    CrossRefPubMed
  29. Simonen P, Hamilton C, Ferguson S, et al. Do inflammatory processes contribute to radiation induced erythema observed in the skin of humans? Radiother Oncol. 1998; 46(1): 73–82.
    CrossRefPubMed
  30. Heissig B, Rafii S, Akiyama H, et al. Low-dose irradiation promotes tissue revascularization through VEGF release from mast cells and MMP-9-mediated progenitor cell mobilization. J Exp Med. 2005; 202(6): 739–750.
    CrossRefPubMed
  31. Denham JW, Hauer-Jensen M. The radiotherapeutic injury--a complex 'wound'. Radiother Oncol. 2002; 63(2): 129–145.
    CrossRefPubMed
  32. McQuestion M. Evidence-based skin care management in radiation therapy: clinical update. Semin Oncol Nurs. 2011; 27(2): e1–17.
    CrossRefPubMed
  33. Mendelsohn FA, Divino CM, Reis ED, et al. Wound care after radiation therapy. Adv Skin Wound Care. 2002; 15(5): 216–224.
    CrossRefPubMed
  34. SERVICES USDOHAH: Common Terminology Criteria for Adverse Events (CTCAE). National Institutes of Health 2009.
  35. Cox JD, Stetz J, Pajak TF. Toxicity criteria of the Radiation Therapy Oncology Group (RTOG) and the European Organization for Research and Treatment of Cancer (EORTC). Int J Radiat Oncol Biol Phys. 1995; 31(5): 1341–1346.
    CrossRefPubMed
  36. Ratliff C. Impaired skin integrity related to radiation therapy. J Enterostomal Ther. 1990; 17(5): 193–198.
    PubMed
  37. Bernier J, Bonner J, Vermorken JB, et al. Consensus guidelines for the management of radiation dermatitis and coexisting acne-like rash in patients receiving radiotherapy plus EGFR inhibitors for the treatment of squamous cell carcinoma of the head and neck. Ann Oncol. 2008; 19(1): 142–149.
    CrossRefPubMed
  38. Bonner JA, Harari PM, Giralt J, et al. Radiotherapy plus cetuximab for locoregionally advanced head and neck cancer: 5-year survival data from a phase 3 randomised trial, and relation between cetuximab-induced rash and survival. Lancet Oncol. 2010; 11(1): 21–28.
    CrossRefPubMed
  39. Wong RKS, Bensadoun RJ, Boers-Doets CB, et al. Clinical practice guidelines for the prevention and treatment of acute and late radiation reactions from the MASCC Skin Toxicity Study Group. Support Care Cancer. 2013; 21(10): 2933–2948.
    CrossRefPubMed
  40. Hymes SR, Strom EA, Fife C. Radiation dermatitis: clinical presentation, pathophysiology, and treatment 2006. J Am Acad Dermatol. 2006; 54(1): 28–46.
    CrossRefPubMed
  41. Lavery BA. Skin care during radiotherapy: a survey of UK practice. Clin Oncol (R Coll Radiol). 1995; 7(3): 184–187.
    CrossRefPubMed
  42. Thomas SJ, Hoole ACF. The effect of optimization on surface dose in intensity modulated radiotherapy (IMRT). Phys Med Biol. 2004; 49(21): 4919–4928.
    CrossRefPubMed
  43. Lee N, Chuang C, Quivey JM, et al. Skin toxicity due to intensity-modulated radiotherapy for head-and-neck carcinoma. Int J Radiat Oncol Biol Phys. 2002; 53(3): 630–637.
    CrossRefPubMed
  44. Vincent C, Dębowska R, Eris I. Care of the skin post radiotherapy. Contemporary Oncology/Współczesna Onkologia. 2007; 11(4): 223–226.
  45. Roy I, Fortin A, Larochelle M. The impact of skin washing with water and soap during breast irradiation: a randomized study. Radiother Oncol. 2001; 58(3): 333–339.
    CrossRefPubMed
  46. Campbell IR, Illingworth MH. Can patients wash during radiotherapy to the breast or chest wall? A randomized controlled trial. Clin Oncol (R Coll Radiol). 1992; 4(2): 78–82.
    CrossRefPubMed
  47. Westbury C, Hines F, Hawkes E, et al. Advice on hair and scalp care during cranial radiotherapy: a prospective randomized trial. Radiother Oncol. 2000; 54(2): 109–116.
    CrossRefPubMed
  48. Watson LC, Gies D, Thompson E, et al. Randomized control trial: evaluating aluminum-based antiperspirant use, axilla skin toxicity, and reported quality of life in women receiving external beam radiotherapy for treatment of Stage 0, I, and II breast cancer. Int J Radiat Oncol Biol Phys. 2012; 83(1): e29–e34.
    CrossRefPubMed
  49. Théberge V, Harel F, Dagnault A. Use of axillary deodorant and effect on acute skin toxicity during radiotherapy for breast cancer: a prospective randomized noninferiority trial. Int J Radiat Oncol Biol Phys. 2009; 75(4): 1048–1052.
    CrossRefPubMed
  50. Lewis L, Carson S, Bydder S, et al. Evaluating the effects of aluminum-containing and non-aluminum containing deodorants on axillary skin toxicity during radiation therapy for breast cancer: a 3-armed randomized controlled trial. Int J Radiat Oncol Biol Phys. 2014; 90(4): 765–771.
    CrossRefPubMed
  51. Miller RC, Schwartz DJ, Sloan JA, et al. Mometasone furoate effect on acute skin toxicity in breast cancer patients receiving radiotherapy: a phase III double-blind, randomized trial from the North Central Cancer Treatment Group N06C4. Int J Radiat Oncol Biol Phys. 2011; 79(5): 1460–1466.
    CrossRefPubMed
  52. Hindley A, Zain Z, Wood L, et al. Mometasone furoate cream reduces acute radiation dermatitis in patients receiving breast radiation therapy: results of a randomized trial. Int J Radiat Oncol Biol Phys. 2014; 90(4): 748–755.
    CrossRefPubMed
  53. Boström A, Lindman H, Swartling C, et al. Potent corticosteroid cream (mometasone furoate) significantly reduces acute radiation dermatitis: results from a double-blind, randomized study. Radiother Oncol. 2001; 59(3): 257–265.
    CrossRefPubMed
  54. HALNAN KE. The effect of corticosteroids on the radiation skin reaction. A random trial to assess the value of local application of prednisolone and neomycin ointment after x-ray treatment of basal cell carcinoma. Br J Radiol. 1962; 35: 403–408.
    CrossRefPubMed
  55. Meghrajani CF, Co HS, Arcillas JG, et al. A randomized, double-blind trial on the use of 1% hydrocortisone cream for the prevention of acute radiation dermatitis. Expert Rev Clin Pharmacol. 2016; 9(3): 483–491.
    CrossRefPubMed
  56. Omidvari S, Saboori H, Mohammadianpanah M, et al. Topical betamethasone for prevention of radiation dermatitis. Indian J Dermatol Venereol Leprol. 2007; 73(3): 209.
    CrossRefPubMed
  57. Schmuth M, Wimmer MA, Hofer S, et al. Topical corticosteroid therapy for acute radiation dermatitis: a prospective, randomized, double-blind study. Br J Dermatol. 2002; 146(6): 983–991.
    CrossRefPubMed
  58. Palatty PL, Azmidah A, Rao S, et al. Topical application of a sandal wood oil and turmeric based cream prevents radiodermatitis in head and neck cancer patients undergoing external beam radiotherapy: a pilot study. Br J Radiol. 2014; 87(1038): 20130490.
    CrossRefPubMed
  59. Liguori V, Guillemin C, Pesce GF, et al. Double-blind, randomized clinical study comparing hyaluronic acid cream to placebo in patients treated with radiotherapy. Radiother Oncol. 1997; 42(2): 155–161.
    CrossRefPubMed
  60. Pinnix C, Perkins GH, Strom EA, et al. Topical hyaluronic acid vs. standard of care for the prevention of radiation dermatitis after adjuvant radiotherapy for breast cancer: single-blind randomized phase III clinical trial. Int J Radiat Oncol Biol Phys. 2012; 83(4): 1089–1094.
    CrossRefPubMed
  61. Ben-David MA, Elkayam R, Gelernter I, et al. Melatonin for Prevention of Breast Radiation Dermatitis: A Phase II, Prospective, Double-Blind Randomized Trial. Isr Med Assoc J. 2016; 18(3-4): 188–192.
    PubMed
  62. Fenig E, Brenner B, Katz A, et al. Topical Biafine and Lipiderm for the prevention of radiation dermatitis: a randomized prospective trial. Oncol Rep. 2001; 8(2): 305–309.
    PubMed
  63. Gosselin TK, Schneider SM, Plambeck MA, et al. A prospective randomized, placebo-controlled skin care study in women diagnosed with breast cancer undergoing radiation therapy. Oncol Nurs Forum. 2010; 37(5): 619–626.
    CrossRefPubMed
  64. Pommier P, Gomez F, Sunyach MP, et al. Phase III randomized trial of Calendula officinalis compared with trolamine for the prevention of acute dermatitis during irradiation for breast cancer. J Clin Oncol. 2004; 22(8): 1447–1453.
    CrossRefPubMed
  65. Løkkevik E, Skovlund E, Reitan JB, et al. Skin treatment with bepanthen cream versus no cream during radiotherapy--a randomized controlled trial. Acta Oncol. 1996; 35(8): 1021–1026.
    CrossRefPubMed
  66. Hemati S, Asnaashari O, Sarvizadeh M, et al. Topical silver sulfadiazine for the prevention of acute dermatitis during irradiation for breast cancer. Support Care Cancer. 2012; 20(8): 1613–1618.
    CrossRefPubMed
  67. Aysan E, Idiz UO, Elmas L, et al. Effects of Boron-Based Gel on Radiation-Induced Dermatitis in Breast Cancer: A Double-Blind, Placebo-Controlled Trial. J Invest Surg. 2017; 30(3): 187–192.
    CrossRefPubMed
  68. Fahl WE. Complete prevention of radiation-induced dermatitis using topical adrenergic vasoconstrictors. Arch Dermatol Res. 2016; 308(10): 751–757.
    CrossRefPubMed
  69. Hoopfer D, Holloway C, Gabos Z, et al. Three-Arm Randomized Phase III Trial: Quality Aloe and Placebo Cream Versus Powder as Skin Treatment During Breast Cancer Radiation Therapy. Clin Breast Cancer. 2015; 15(3): 181–90.e1.
    CrossRefPubMed
  70. Heggie S, Bryant GP, Tripcony L, et al. A Phase III study on the efficacy of topical aloe vera gel on irradiated breast tissue. Cancer Nurs. 2002; 25(6): 442–451.
    CrossRefPubMed
  71. Falkowski S, Trouillas P, Duroux JL, et al. Radiodermatitis prevention with sucralfate in breast cancer: fundamental and clinical studies. Support Care Cancer. 2011; 19(1): 57–65.
    CrossRefPubMed
  72. Sharp L, Finnilä K, Johansson H, et al. No differences between Calendula cream and aqueous cream in the prevention of acute radiation skin reactions--results from a randomised blinded trial. Eur J Oncol Nurs. 2013; 17(4): 429–435.
    CrossRefPubMed
  73. Dirier A, Akmansu M, Bora H, et al. The effect of vitamin E on acute skin reaction caused by radiotherapy. Clin Exp Dermatol. 2007; 32(5): 571–573.
    CrossRefPubMed
  74. Aygenc E, Celikkanat S, Kaymakci M, et al. Prophylactic effect of pentoxifylline on radiotherapy complications: a clinical study. Otolaryngol Head Neck Surg. 2004; 130(3): 351–356.
    CrossRefPubMed
  75. Becker-Schiebe M, Mengs U, Schaefer M, et al. Topical use of a silymarin-based preparation to prevent radiodermatitis : results of a prospective study in breast cancer patients. Strahlenther Onkol. 2011; 187(8): 485–491.
    CrossRefPubMed
  76. Melo AM, Alves DS, Pereira AKT, et al. A new perspective in the treatment of radiodermatitis. Indian J Cancer. 2015; 52(4): 544–545.
    CrossRefPubMed
  77. Harper JL, Franklin LE, Jenrette JM, et al. Skin toxicity during breast irradiation: pathophysiology and management. South Med J. 2004; 97(10): 989–993.
    CrossRefPubMed
  78. Sekiguchi K, Ogita M, Akahane K, et al. Randomized, prospective assessment of moisturizer efficacy for the treatment of radiation dermatitis following radiotherapy after breast-conserving surgery. Jpn J Clin Oncol. 2015; 45(12): 1146–1153.
    CrossRefPubMed
  79. Bazire L, Fromantin I, Diallo A, et al. Hydrosorb® versus control (water based spray) in the management of radio-induced skin toxicity: Results of multicentre controlled randomized trial. Radiother Oncol. 2015; 117(2): 229–233.
    CrossRefPubMed
  80. WINTER GD. Formation of the scab and the rate of epithelization of superficial wounds in the skin of the young domestic pig. Nature. 1962; 193: 293–294.
    CrossRefPubMed
  81. Diggelmann KV, Zytkovicz AE, Tuaine JM, et al. Mepilex Lite dressings for the management of radiation-induced erythema: a systematic inpatient controlled clinical trial. Br J Radiol. 2010; 83(995): 971–978.
    CrossRefPubMed
  82. Duncan W, MacDougall RH, Kerr GR, et al. Adverse effect of treatment gaps in the outcome of radiotherapy for laryngeal cancer. Radiother Oncol. 1996; 41(3): 203–207.
    CrossRefPubMed
  83. Eberlein T, Assadian O. Clinical use of polihexanide on acute and chronic wounds for antisepsis and decontamination. Skin Pharmacol Physiol. 2010; 23 Suppl: 45–51.
    CrossRefPubMed
  84. Harati K, Kiefer J, Behr B, et al. The use of Prontosan® Wound Gel X in partial and full thickness burns requiring split thickness skin grafts – an interim analy sis. Ann Burns Fire Disasters. 2015; 27: 292–296.
  85. Shah C. Polyhexamethylene biguanide (PHMB) treated wound dressings and vancomycin-resistant enterococci (VRE). Man- aging Infect Control. 2007; 7: 26–34.
  86. Kirker KR, Fisher ST, James GA, et al. Efficacy of Polyhexamethylene Biguanide-containing Antimicrobial Foam Dressing Against MRSA Relative to Standard Foam Dressing. Wounds. 2009; 21(9): 229–233.
    PubMed
  87. Robertson C, Robertson AG, Hendry JH, et al. Similar decreases in local tumor control are calculated for treatment protraction and for interruptions in the radiotherapy of carcinoma of the larynx in four centers. Int J Radiat Oncol Biol Phys. 1998; 40(2): 319–329.
    CrossRefPubMed
  88. Wound Healing and Management Node Group. Evidence summary: polyhexamethylene biguanide (PHMB) wound dressings. Wound Pract Res. 2013; 21: 82–85.
  89. Bey E, Prat M, Duhamel P, et al. Emerging therapy for improving wound repair of severe radiation burns using local bone marrow-derived stem cell administrations. Wound Repair Regen. 2010; 18(1): 50–58.
    CrossRefPubMed
  90. Lataillade JJ, Doucet C, Bey E, et al. New approach to radiation burn treatment by dosimetry-guided surgery combined with autologous mesenchymal stem cell therapy. Regen Med. 2007; 2(5): 785–794.
    CrossRefPubMed

Regulations

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

Wydawcą serwisu jest VM Media Group sp. z o.o., ul. Świętokrzyska 73, 80–180 Gdańsk

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail: viamedica@viamedica.pl