Medical management of radiation burns - some experiences

Localized exposure resulting in radiation burns are serious injuries, seen not only in this country but all over the world. All of these injuries have resulted from accidents in Industrial Radiography (non-destructive testing). In our country all these injuries have occurred in the private sectors who handle these radiography sources. These sources can be of Iridium-192 or Cobalt-60. Some of these accidents have occurred involving trained radiographers but sometimes casual workers have been exposed. Skin is highly vulnerable to the external radiation exposure. Damage of varying extent can be seen following radiotherapy and accidents involving X- and gamma-ray sources. The reaction is related to the absorbed dose, which in turn is dependent upon the energy of radiation and weather it is particulate or electromagnetic radiation. Beta particles give up their energy within a short range and hence are more hazardous. Radiation burns develop slowly and blister formation occurs usually after 4 weeks. After exposure the skin response occurs in the form of transient erythema, fixed erythema, transepidermal burns, full thickness radiation burns and epilation. In radiation accidents, particularly those involving X-ray machines, the patients may not be aware of the time of accident and the dose may not be known in those circumstances. The medical management and treatment of such patients, therefore, has its own challenges. This talk will share some experiences on treatment of radiation injuries. (author)