Management of Malignant Fungating Wound in Palliative Care – A Nursing Perspective

Abstract

Introduction-Malignant fungating wounds are probably one of the most distressing signs for patients having advanced cancer of head and neck and breast. The goal is to maintain and improve quality of life through symptom control.
Methodology –25 adult patients with advanced head and neck cancer and breast cancer presenting with fungating wound were enrolled in this study. Symptoms and wound were assessed using Wound Assessment Tool at day 1 and on Days 15 after continuous palliative nursing and medical care at home or hospice. All the patients received dressing and symptomatic treatment accordingly for pain, exudates, malodor, bleeding.
Results- In this study, we found statistically significant improvement (P = <0.05) in scores of wound and all other related symptoms on days 15. Most common symptoms were pain (6.28±0.84), exudate (4.64±0.81), malodor (6.96±1.02), and bleeding (2.44±1.50). After 15 days with palliative intervention, greater number of patients experienced improvement in their symptom profile like pain (2.20±0.91), exudates (1.88±0.83), malodor (2.40±0.65), and bleeding (0.36±0.57).
Conclusion- Malignant fungating wound in advanced cancer of head and neck and breast showed a significant local symptomatic burden on patients as well as caregiver. Significant intervention for wound care reduces the symptoms burden and thereby improve the quality of life of patients and care givers.