PULVERIZED METRONIDAZOLE FOR NEOPLASTIC WOUNDS DURING RADIOTHERAPY TREATMENT : CASE STUDY

Patients presenting neoplastic wounds during radiotherapy treatment on private hospital at Sao Paulo City. Patient A, an 70 years old patient was diagnosed with stage II squamous cell carcinoma (SCC) of the scalp in December of 2018. 35 sessions of Radiotherapy of head was indicated. Patient completed 30 sessions between January and march of 2019. On first session, presents 16cm x 5cm neoplastic wound, vegetative tissue, stage III purulent exudate with strong odor (score 4). Patient B, an 52 years old patient with GH1GN1 left breast invasive carcinoma. 13 sessions of Radiotherapy was indicated and completed. Since February of 2019 presents neoplastic wound. On first session presents 15cm X 15cm neoplastic wound, vegetative tissue, stage II purulent exudate with moderate odor (score 3). Interventions: Patient A – Crushed Metronidazole 250mg tablets pulverized after each session of radiotherapy. Homecare management with polihexanide associated to silver hydroalginate dressing was indicated. Patient B – Crushed Metronidazole 250mg tablets pulverized after each session of radiotherapy. Homecare management with polihexanide associated to silver sulfadiazine cream and cerium nitrate was indicated. Outcomes: Patient A – Neoplastic wound presents 10cm x 1cm and no odor (score 1) purulent exudate stage I. Patient B – Neoplastic wound presents 10cm x 10cm and no odor (score 1) purulent exudate stage I. Conclusions: Concerning guidelines to metronidazole administration on neoplastic wounds treatment, and considering low costs and easy accessibility for patients we decide to use pulverized tablets. During treatment was possible to note decrease of wound size and exudate odor and an improvement on patients quality of life.