Post-radiation damage to skin tissue on the back during fibrosarcoma treatment

Skin damage is a frequent complication of oncological treatment. Due to tissue changes, the regenerative processes of the skin are impaired, which poses a challenge in the care of this group of patients. The selection of recommended forms of treatment is to ensure that the inflammatory reaction is reduced and the tissue regeneration process is carried out/occurs as quickly as possible. The aim of the study was to present the local treatment process for a radiation wound resulting from dermatofibrosarcoma protuberans treatment. The study employed a case study approach. The study design was based on the CARE guidelines. The patient was a 42-year-old individual who underwent radical resection of a nodular fibrosarcoma in the dorsal region, followed by brachytherapy in the lumbar area. Following oncological treatment, inflammation and necrosis of the skin and subcutaneous tissue (CTCAE 4°/grade 4) occurred. Negative pressure wound therapy (NPWT) and tissue debridement with maggot debridement therapy (MDT) were administered, however these treatments provided a limited therapeutic effect. A wide excision of the damaged tissues up to the fascia was performed, followed by administering NPWT again. The nursing interventions undertaken aimed to facilitate professional wound management, promote tissue repair and minimize pain. Interventions also focused on increasing the patient’s comfort level by reducing anxiety and encouraging active participation in the healing process. The methods used – NPWT and MDT – influenced the achievement of physiological healing processes and reduction of the wound area. The healing process of a wound caused by radiation damage is lengthy and susceptible to complications related to disturbances in physiological regenerative processes and chronic inflammation.