A Randomized Control Trial Comparing Time to Healing of Radiation Induced Acute Skin Reactions Using Biological Membrane Dressing or Topical Methyl Pararosaniline Dye.

Abstract

Management of radiation induced acute skin toxicity warrants titration between the overall treatment time necessary for optimal tumor control and treatment breaks necessary for repair of normal tissue toxicity. Hence interventions that reduce the treatment break time by promoting tissue repair becomes an absolute requisite. Biological (Amniotic) membrane, the innermost layer of placenta, has shown to induce re-epithelialization, regulate angiogenesis and reduce inflammation. The antibacterial, antifungal, and anthelminthic properties of methylpararosaniline dyes facilitates its use in acute skin reactions to prevent secondary infections and hence promote tissue healing. We have compared the time to acute skin reaction healing in head and neck and breast carcinomas when augmented with biological membrane dressing or topical methylpararosaniline dye MATERIALS/METHODS: 30 patients of head and neck and breast carcinomas undergoing radiation therapy with radiation induced acute grade III skin toxicity (RTOG GRADING), were randomized to receive biological membrane dressing or topical methylpararosaniline dye application. Patients were reviewed every alternate day till tissue healing and restart of radiation.In biological membrane dressing group,53% of cases had tissue repair in 4 days, 40% in 6 days and 7% in over 7 days whereas in topical dye group, 7% had tissue repair in 4 days,40% in 6 days and in 53% over 6 days.In our observation, addition of biological membrane dressing has reduced the treatment break time by promoting tissue healing, surpassing the healing augmented by topical dye application.