Vitamin B12

Vitamin B12 is produced by the liver and is involved in several biochemical metabolic reactions. It promotes the repair of damaged skin mucous membranes and vascular endothelial cells, reduces spasm and occlusion of blood vessels, improves local blood flow and prevents the deterioration of wound infection. In addition, it reduces the excitability of pain fibers C and AG, leading to an analgesic effect. Vitamin B12 injections to the skin in the radiation field benefit the wound by reducing irritation and pain, preventing rupture and enhancing new epithelial resistance to radiation, thereby promoting healing of the skin. Chen et al used a vitamin B12 solution to treat radiation-induced moist dermatitis. The cure rate at 10 days was 100%, which was significantly different from the control group.

Clinical experience

Clinical experience should be considered in the overall benefit-risk profile for the device where the totality of the data available for the device may inform whether more testing is needed, or if any testing is needed at all. For example, clinical experience may be useful to mitigate problematic findings in an in vitro biocompatibility. In other cases, testing to address long-term biocompatibility endpoints may not be necessary if the patient’s life expectancy in the intended use population is limited. Generally, clinical studies are not sufficiently sensitive to identify biocompatibility concerns. Clinical or sub-clinical symptoms that result from the presence of a non-biocompatible material may not be identifiable, or may result in symptoms that are indistinguishable from the disease state such that the clinical data may not be informative to the biocompatibility evaluation. For example, blood vessel occlusion at the site of an implanted stent could be indicative of a toxic response to the stent materials or be related to damage to the stent during implantation.

Multidisciplinary Care

Given the increasing complexity of the residents care needs combined with the call for a palliative approach to care delivery suggests that the adoption of a multi-disciplinary team approach to care planning and delivery is required. Multidisciplinary care is the vehicle for providing an integrated team approach to the provision of health care and this occurs when medical, nursing and allied health professionals consider all treatment options, including all of the potential benefits and disadvantages of treatment decisions, personal preferences of the resident and collaboratively develop an individual care plan that best meets the needs of each resident and their family. There is compelling evidence to suggest that a multi-disciplinary approach to care helps to enhance the residents quality of life by addressing the problems that are of most concern to the resident are addressed, reduces ambiguity around treatment and the goals of care, ensures that care decisions are based on best evidence based practice.