BACKGROUND: Surface-guided radiation therapy (SGRT) has emerged as a powerful tool to improve patient setup accuracy in radiation therapy (RT). Combined with the goal of increasing RT accuracy is an ongoing effort to decrease RT side effects. The application of a prophylactic skin dressing to the treatment site is a well-documented method of reducing skin-related side effects from RT. This paper aims to investigate whether the application of Mepitel, a prophylactic skin dressing, has an impact on the accuracy of surface-guided patient setups in chest wall RT.
METHODS: A retrospective analysis of daily image-guided Online Corrections (OLCs) from patients undergoing chest wall irradiation with SGRT was performed. Translational (superior-inferior, lateral, and anterior-posterior) OLC magnitude and direction were compared between patients treated with Mepitel applied and those treated without. Systematic and random errors were calculated and compared between groups.
RESULTS: OLCs from 275 fractions were analysed. Mean OLCs were larger for patients with Mepitel applied in the superior_inferior axis (0.34 vs. 0.22 cm, P = 0.049) and for the combined translational vector (0.54 vs. 0.43 cm, P = 0.043). Combined translational systematic error was slightly larger for patients with Mepitel applied (0.15 vs. 0.09 cm).
CONCLUSIONS: Mepitel can impact the accuracy of SGRT patient-positioning in chest wall RT. The variation however is small and unlikely to have any clinical impact if SGRT is coupled with image guidance and appropriate PTV margins. Further investigation is required to assess the effect of Mepitel on SGRT accuracy in other treatment sites, as well as any potential dosimetric impacts.

Pyoderma gangrenosum (PG) is a rare skin disorder primarily treated with immunosuppression medication. We report a case of a large, chronic PG wound treated with adjunct negative pressure wound therapy with instillation and dwell time (NPWTi-d) using nonadherent dressing (Mepitel) and reticular open-cell foam with through holes (ROCF-CC) with positive outcomes. The patient was a 62-year-old female with rheumatoid arthritis, Hashimoto\'s thyroiditis, lymphedema, and morbid obesity who presented with a 19.5 cm x 13.2 cm x 2.1 cm wound of three years duration on the right posterolateral lower extremity that successfully responded to a multimodality approach of immunosuppression and wound vac therapy. We conclude in our case that NPWTi-d with Mepitel and ROCF-CC enhanced the wound healing process, and we discuss NPWTi-d\'s potential role and benefit as an adjunctive therapy option for chronic and poorly controlled PG on patients taking concurrent immunosuppression.

OBJECTIVE: To compare the healing effects of dried and acellular human amniotic membrane and Mepitel for coverage of split-thickness graft donor site (STGDS).
METHODS: Twenty patients who underwent STGDS regeneration surgery in identical anatomic regions were enrolled in this randomized controlled clinical trial conducted in Hazrate Fatemeh hospital (Iran). Patients were randomly assigned in 3 groups of wound dressing; group A by Mepitel, group B AmiCare (Dried amniotic membrane) and group C OcuReg-A (Acellular amniotic membrane). Re-epithelization rate (healing time), pain sensation, scar formation and infection rate were assessed till complete healing was achieved.
RESULTS: Our results showed no significant difference between Amicare, OcuReg-A and Mepitel in the features analyzed by us including: Re-epithelization rate (healing time) P value; 0.573, Pain sensation P value: day 4 th: 0.131, day8 th: 0.93 and day 12 th: 0.365, Scar formation P value>0.05and Infection rate.
CONCLUSIONS: Our findings confirmed the safety and efficacy of AmiCare (dried amniotic membrane) and OcuReg-A (Acellular amniotic membrane) in treatment of split-thickness donor site in comparison with Mepitel as a standard wound dressing. Trial registration number: IRCT201511118177N12.

Elective surgeries account for millions of acquired scars annually. Many of these scars can be problematic, being aesthetically unpleasant and causing discomfort. Silicone gel sheeting has been shown to be efficacious for the prevention and treatment of problematic scars. By wound hydration, along with other factors, silicone dressings are thought to decrease scarring. However, we found the usual treatment was commonly started after epithelialization of the incision site. The current standard of care in wound healing is to promote a moist wound environment to ensure quick epithelialization and decrease excessive scar formation. With that standard in mind, after foot surgery was performed on 2 patients, silicone sheeting was applied immediately in order to compare its effects with those of standard moist wound healing (XEROFORM Petrolatum Gauze).