Malignant fungating wounds: epidemiology, aetiology, presentation and assessment

Alexander, Susan J.

doi:10.12968/jowc.2009.18.7.43110

Cited by 65 publications

(43 citation statements)

References 50 publications

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“…Another drawback of the current study could be that the primary outcome was wound size. The scarcity of literature on healing MWs is probably due to the fact that healing MWs is an unrealistic goal due to the underlying cancer disease . However, the most important issues for the patients with MWs include malodor, exudation, and cleanliness, and as such, we recommend that future research focus on these issues and not on wound size alone.…”

Section: Discussionmentioning

confidence: 99%

“…In the literature, malignant wounds (MWs) are described as chronic wounds that occur in 5–10% of all cancer patients . MWs are most often seen in connection with breast cancer, head and neck cancer, and in advanced cancer cases .…”

mentioning

confidence: 99%

“…Guidelines for treating MWs are usually developed based on experience rather than on evidence from randomized clinical trials (RCTs) . Research is lacking on treatment strategies and wound care products that facilitate healing and that meet the patient's physical and psychosocial needs …”

mentioning

confidence: 99%

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The effect of honey‐coated bandages compared with silver‐coated bandages on treatment of malignant wounds—a randomized study

Lund-Nielsen

Adamsen

Kolmos

et al. 2011

Wound Repair Regeneration

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Malignant wounds (MWs) occur in 5-10% of all cancer patients. Malodor and exudation are the most common side effects. The aim was to determine the influence of honey-coated compared with silver-coated bandages on treatment of MWs. Patients were randomly selected to enter either group A (honey-coated bandages) or group B (silver-coated bandages). Parameters were the following: wound size, cleanliness, malodor, exudation, and wound pain. Digital photographs, visual analog scales (VAS), and wound morphology registration were used for measurement at baseline and following the 4-week intervention. Sixty-nine patients with MWs and advanced cancer, aged 47-90 (median 65.6), were included. No statistically significant difference was noted between the groups with respect to wound size, degree of cleanliness, exudation, malodor, and wound pain. There was a median decrease in wound size of 15 cm² and 8 cm² in group A and B, respectively (p = 0.63). Based on post-intervention pooled data from the groups, improvement was seen in 62% of the participants with respect to wound size and in 58% (n = 69) with respect to cleanliness. The VAS score for malodor (p = 0.007) and exudation (p < 0.0001) improved significantly post-intervention. Patients with reduced wound size had a median survival time of 387 days compared with 134 days in patients with no wound reduction (p = 0.003). The use of honey-coated and silver-coated bandages improved the outcome of MWs. No differences were found between the two regimens. Both types of bandages are recommended for use by patients with MWs containing tumor debris and necrosis.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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The effect of honey‐coated bandages compared with silver‐coated bandages on treatment of malignant wounds—a randomized study

Lund-Nielsen

Adamsen

Kolmos

et al. 2011

Wound Repair Regeneration

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“…The literature review conducted to determine the current state of malignant wound knowledge has been reported elsewhere (2–5). The review showed only two studies that investigated the lived experience of malignant wounds from the perspectives of patients (6,7) and another that investigated how malignant wounds affected the femininity, sexuality and daily life of female breast cancer patients (8).…”

Section: Background and Literature Reviewmentioning

confidence: 99%

An intense and unforgettable experience: the lived experience of malignant wounds from the perspectives of patients, caregivers and nurses

Alexander

2010

International Wound Journal

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Malignant wounds occur infrequently, but are typically described as devastating and overwhelming. However, there has been little formalised research, and the vast majority of existing malignant wound literature comprises reports of health care professionals from their management of the physical symptoms. Few studies have investigated the lived experience from the perspectives of patients and nurses and none have investigated the experiences of lay caregivers caring for a patient with a malignant wound. As a result, there has been little mention in existing literature of the non physical issues associated with malignant wounds or how they might be addressed. The purpose of this study was to address this gap in knowledge by investigating the lived experience of malignant wounds from the perspectives of those living it. In-depth interviews were conducted with patients, caregivers and nurses. The data were analysed thematically within a hermeneutic phenomenological methodology to show four themes: (i) malodour; (ii) new mode of being-in-the-world; (iii) still room for hope and (iv) enduring memories. Although this study confirmed previous findings that malodour was one of the worst aspects of malignant wounds, it was significant that the other three themes occurred in the previously largely overlooked psychosocial domain.

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“…Self‐treatment of chronic wounds involves wound cleansing, wound inspection, applying and removing wound dressings and/or applying and removing other therapies such as compression bandaging . How and why individuals self‐treat chronic wounds has not been systematically investigated, although this practice has been noted as preferable and acceptable in case study research and is reported to occur among individuals who have malignant wounds .…”

Section: Introductionmentioning

confidence: 99%

How and why patients self‐treat chronic wounds

Kapp

Santamaria

2017

International Wound Journal

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The aim of this study was to investigate how people self-treat chronic wounds, why they self-treat and the assistance and support that they receive. The increasing emphasis on self-management of chronic conditions, the potential benefits of self-treatment to the health care consumer and competing demands on health care funding are good reasons to investigate self-treatment of chronic wounds as we have little data on this group of individuals. A survey study was conducted in Australia. A non-random sample of 100 participants was recruited. Participants were aged 18 years or older and currently or previously had a chronic wound that they self-treated. All participants completed one survey. Data analysis involved descriptive statistics. The sample was, on average, 64·6 years of age; half was female (n = 50, 50%), and the majority had a lower leg wound (n = 80, 80·0%). The sample scored 33·9/40 on the Generalized Self-efficacy Scale and 68/100 on the Medical Outcomes Social Support Scale. The majority of the 89 participants who used a wound dressing used a product that targeted bacteria (n = 59, 66.3%). The two most commonly selected reasons for self-treating were 'to be independent' (n = 58, 58·0%) and 'to do the treatment at a time that suited' (n = 55, 56·0%). Less than one quarter of participants reported being supervised regularly during the wound episode (n = 22, 22%), and few (n = 6, 6·0%) reported having received education and training to support their self-treatment. Self-treaters of chronic wounds may benefit from standardised education and closer professional supervision to optimise self-treatment practices. Efforts to improve patient satisfaction with professional care are required to promote a shared-care model when self-treating and to optimise patient outcomes.

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Malignant fungating wounds: epidemiology, aetiology, presentation and assessment

Abstract: These wounds can be devastating for patients and challenging for practitioners. This article, the first in a series, examines the research literature on their aetiology and presentation, and suggests how they might be most effectively assessed

Cited by 65 publications

References 50 publications

The effect of honey‐coated bandages compared with silver‐coated bandages on treatment of malignant wounds—a randomized study

The effect of honey‐coated bandages compared with silver‐coated bandages on treatment of malignant wounds—a randomized study

An intense and unforgettable experience: the lived experience of malignant wounds from the perspectives of patients, caregivers and nurses

How and why patients self‐treat chronic wounds

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