The road to fighting cancer is long and tortuous, and it may not be the cancer cells that will defeat you on this road, but the infection. Co-infection in cancer patients can exacerbate the disease and become a leading cause of death [1]. Therefore, infection prevention is one of the key factors that determine the longevity and better life of cancer patients.
There are many sites of cancer co-infection, and we have previously introduced the 3 common conditions of respiratory tract infection, urinary tract infection, and bloodstream infection and preventive measures (click for details: it may not be cancer cells that will defeat you, but this roadblock, pay attention to avoid these situations!). The oral cavity, abdominal cavity, skin, and soft tissues are also common sites of infection in cancer patients [2], and we continue to learn today!
1 Oral infections
▍What causes oral infections?
Because the patient's autoimmunity is already very poor, and the oral mucosa will be damaged after chemotherapy and radiotherapy; If there is caries, gingivitis, and apical periodontitis in the oral cavity, pre-existing diseases can lead to oral infection; In addition, oral infections can be induced by reduced water intake and food intake [3-5].
▍How to avoid oral infections? [3-5]
Oral infections can lead to systemic infections, affect the effectiveness of chemotherapy for patients, increase patient suffering, and in severe cases, can be life-threatening. Therefore, good oral care is of great significance for the prevention of oral infections and systemic infections, and it is recommended that:
(1) Eat less raw, cold, sticky food, and do not eat hot or irritating foods that are irritating or irritating to the oral mucosa; At the same time, it is necessary to avoid hard or fibrous foods to prevent damage or embedding between the teeth. Once food impaction is done, the impaction should be removed properly.
(2) To keep the mouth clean, protect teeth and dental caries. Use a soft-bristled toothbrush and non-irritating toothpaste when brushing your teeth.
(3) People with low platelets should pay attention to rinsing their mouths instead of brushing their teeth, or brush their teeth with a soft-bristled toothbrush as much as possible, and do not use a toothpick to pick their teeth.
Gargling method: Rinse your mouth every morning, 30min after each meal and before going to bed, and let your tongue stir up, down, left and right in the mouth each time to strengthen the movement of the mouth. Let the mouthwash stay in the oral cavity for 3~5min, so that the mouthwash can fully contact the mucosal fold part to achieve better results.
(4) During the treatment period, pay attention to regular oral examination, pay attention to observe whether the oral mucosa has congestion, erythema, erosion, ulcer, bleeding, and notify the doctor in time if there is any abnormality.
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Featured Topic: Cancer Infection
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2. Intra-abdominal infection
▍What causes intra-abdominal infection?
Patients with abdominal tumors are prone to perforation of the digestive system and anastomotic leakage (such as perforation of gastrointestinal tumors due to obstruction and chemoradiotherapy; intestinal obstruction and intestinal necrosis; Parenteral fistula complicated by surgery for gastrointestinal tumors), coupled with the fact that cancer patients usually receive various anti-tumor therapies such as immunosuppressants and chemoradiotherapy, which further disrupt the patient's immune function, and the risk of postoperative abdominal infection is high [6-9].
▍How can I avoid intra-abdominal infection [10-11]?
(1) Strengthen nutritional support treatment.
(2) Active blood sugar control: For patients with underlying diseases, especially diabetic patients, their blood sugar levels are relatively high, which is more conducive to the growth and reproduction of bacteria, and is very prone to incision infection.
(3) Semi-recumbent position, more bed activities, help the absorption of intra-abdominal fluid and blood, and reduce the incidence of intra-abdominal infection.
(4) Quitting smoking at least 2 weeks before surgery can reduce the incidence of infection.
(5) Pay attention to protect the abdominal drainage tube to avoid catheter slippage. If the drain slips, causing blood and fluid in the abdominal cavity to not drain, the chance of infection increases.
3. Skin and soft tissue infections
Skin and soft tissue infection is an inflammatory disease, which is mainly caused by the invasion of epidermis, dermis and subcutaneous tissues by pathogenic microorganisms, and the invasion site can be red, swollen, hot and painful.
▍What causes skin and soft tissue infections?
Radiation dermatitis can lead to thinning of the skin and radiation dermatitis [12-13], which has low resistance and is prone to skin and soft tissue infections after scratching the skin. Frequent infusions disrupt the integrity of the skin and increase the likelihood of skin infection [14]; Cancer patients are prone to perianal skin infections due to weak body and long-term bed rest, poor air circulation around the skin and soft tissues, and frequent fecal irritation by the perianal area and external communication with the outside world [15].
▍How to avoid skin and soft tissue infections?
(1) Keep the skin clean and dry, rub frequently, change clothes frequently, and turn over frequently.
(2) Cancer patients can do some exercises in bed under the guidance of physicians after surgery or chemotherapy to improve the body's immunity, and later can get out of bed to exercise according to the recovery status of the body to avoid skin and soft tissue infections caused by long-term bed rest [16-17].
(3) For patients who need radiotherapy, it is recommended that you wear loose, soft, cotton, absorbent underwear, and keep your skin clean and dry. Avoid applying harsh drugs such as iodine tincture, red mercury, alcohol, and soap to irradiated wild skin. When the skin is itchy, you should not scratch it with your hands to prevent skin damage, ulceration, and secondary infection. Avoid rubbing and sun exposure to the skin to avoid skin ulceration and secondary infection [12-13].
(4) After the end of the infusion, remember to press the blood vessel for 5 minutes, cover it with sterile gauze if necessary, and frequently observe the skin symptoms after the needle is withdrawn to avoid infection [14].
(5) It is recommended to wash the anal area with warm water and wet wipes after each bowel movement, eat food that is easy to digest, light and rich in crude fiber, avoid spicy and irritating food, defecate regularly every day, and give Kaiserol or laxatives in time when constipation. Pay attention to changes in the skin and mucous membranes around the anus, and consult a physician promptly if redness, swelling, heat, and pain occur [15].
In short, on the road to fighting cancer, in addition to preventing recurrence and metastasis, we must also be vigilant against another invisible enemy - infection.
References:[1]Mou Xiangling,Yan Shurong,Wang Zuorong. Chinese Journal of Hospital Infection,2013,23(15):3647-3649. [2] Liu Jing, Li Weiguang, Zhu Qifeng. Chinese Journal of Nosocomial Infection,2009,19(17):2271-2273. [3] Zhu Haizhen, Buy Xinlian. Nursing experience of oral infection in patients with cancer chemotherapy[J].Chinese Community Physician(Semi-monthly Journal of Medical Profession),2009,11(21):205.) [4] Sarengeril. Inner Mongolia Medical Journal,2012,44(S6):22-23.DOI:10.16096/j.cnki.nmgyxzz.2012.s6.091. [5] Tian Zhaohua. Nursing measures for preventing infection in patients with radiotherapy and chemotherapy[J].Modern Distance Education of Chinese Medicine,2012,10(09):127-128.) [6] Zhang Baoyun, Zhao Qingyu, Fang Yi, et al. Chinese Journal of Hospital Infectious Diseases,2015,25(21):4937-4940.) [7] Wu Xiuwen, Ren Jian'an. Chinese Journal of Practical Surgery,2020,40(01):1-16.DOI:10.19538/j.cjps.issn1005-2208.2020.01.01. [8] Li Shikuan, Wang Peige. Prevention and treatment of abdominal infection caused by intestinal necrosis intestinal perforation[J].Chinese Journal of Practical Surgery,2016,36(02):182-184[9]张文芳,郑山,李丁,et al. Analysis of drug resistance of infected bacteria in postoperative peritoneal drainage fluid of cancer patients[C]//Chinese Medical Association, Laboratory Branch of Chinese Medical Association, Clinical Laboratory Management Committee of Chinese Hospital Association. Proceedings of the 9th National Conference on Laboratory Medicine of the Chinese Medical Association and the 6th National Conference on Clinical Laboratory Management of the Clinical Laboratory Management Committee of the Chinese Hospital Association. Department of Clinical Laboratory, Affiliated Cancer Hospital of Tianjin Medical University; ,2011:1. [10] Lin Wenjun, Li Yuan. Analysis of risk factors related to intraperitoneal infection after colorectal cancer surgery[J].Henan Journal of Surgery,2022,28(05):33-35.DOI:10.16193/j.cnki.hnwk.2022.05.060. [11] Ye Han, Liang Silong, Huang Yifei. Distribution of pathogenic bacteria and pharmaceutical monitoring of abdominal infection after gynecologic tumor surgery[J].China Family Planning and Obstetrics and Gynecology,2021,13(04):77-80+94.) [12] Sarengeril. Inner Mongolia Medical Journal,2012,44(S6):22-23.DOI:10.16096/j.cnki.nmgyxzz.2012.s6.091. [13] Luo Pre. Factors and control measures related to nosocomial infection in radiotherapy patients in radiotherapy department[J].World Latest Medical Information Abstracts,2015,15(62):178.) [14] Mao M, Liao M, Mao J, et al. Clinical Medicine Research and Practice,2020,5(31):42-43.DOI:10.19347/j.cnki.2096-1413.202031012. [15] He Chunying, Li Fengming. Analysis and nursing of leukemia complicated with perianal skin infection[J].Journal of Yan'an University(Medical Sciences),2004,(02):78.) [16] Wang Yongjin, Wang Juan, He Gang. Clinical Misdiagnosis and Mistreatment,2016,29(02):113-116. [17] Wang Yun. Chinese Journal of Infection and Chemotherapy,2023,23(03):415-416.)
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