RCT on gentian violet versus a hydrogel dressing for radiotherapy-induced moist skin desquamation.
OBJECTIVE
Radiotherapy-induced moist desquamation is a significant problem but there is a paucity of randomised data on which to base treatment decisions. The current prospective randomised trial compared gentian violet (GV) to a hydrogel dressing in this context.


METHODS
Thirty patients undergoing radiotherapy to the head and neck region or breast who had developed moist desquamation in the radiotherapy field were randomised to treatment with 0.5% aqueous gentian violet (GV) (n=16) or a hydrogel dressing (n=14). The area of desquamation was regularly measured until healing or withdrawal from the study.


RESULTS
The likelihood of healing with the hydrogel was greater than GV with a hazard ratio for healing of 7.95 (95% CI 2.20-28.68; p=0.002). The median time to healing for hydrogel was 12 days but had not been reached for GV by 30 days. Over the first 14 days the median'area under curve' of moist desquamation for GV was 82.6 cm2 (range 31.8-320.7 cm2) and that for hydrogel 20.0 cm2 (range 3.8-301.0 cm2) (difference significant at p=0.003). Ten of 16 patients treated with GV withdrew from the study (due to stinging in five and failure to heal in five) compared with two of the 14 treated with hydrogel (difference significant at p=0.021).


CONCLUSIONS
Hydrogel dressings are more likely to heal radiotherapy-induced moist desquamation and are better tolerated than GV.
Gollins
S
S
North Wales Cancer Treatment Centre, Glan Clwyd Hospital, Bodelwyddan, UK. simon.gollins@cd-tr.wales.nhs.uk
Gaffney
C
C
Slade
S
S
Swindell
R
R
D000368:Aged; D000891:Anti-Infective Agents, Local / Q000009:adverse effects / Q000627:therapeutic use*; D047070:Bandages, Hydrocolloid; D001943:Breast Neoplasms / Q000532:radiotherapy; D015400:Clinical Nursing Research; D005260:Female; D005840:Gentian Violet / Q000009:adverse effects / Q000627:therapeutic use*; D006258:Head and Neck Neoplasms / Q000532:radiotherapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009730:Nursing Assessment; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011855:Radiodermatitis / Q000209:etiology / Q000473:pathology / Q000517:prevention & control*; D011879:Radiotherapy Dosage; D017592:Skin Care / Q000009:adverse effects / Q000379:methods / Q000451:nursing; D018709:Statistics, Nonparametric; D013997:Time Factors; D016896:Treatment Outcome; D014945:Wound Healing
D000891:Anti-Infective Agents, Local; D005840:Gentian Violet