Skip to main content

Dealing with a Wound in Palliative Care

  • Reference work entry
  • First Online:
Textbook of Palliative Care
  • 209 Accesses

Abstract

Wounds are a significant issue in palliative care, and to deliver the best wound management, it is essential to understand the principles of wound management and how the body heals. The pathophysiology of wound cause is an essential part of wound assessment as treatment is based on a clear diagnosis of the underlying etiology. The management of a wound in palliative care will be impacted by specific issues such as pain, odor, exudate, and infection. Although it may not be possible to prevent all wounds, good skin care is important. The principles of wound assessment and wound management including the specific problems are explained.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 819.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 1,099.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Addison H, Richard S. Fungating metastatic breast cancer, a challenging case report of bleeding control and palliative wound care. Eur J Prevent Med. 2014;2(3):29–32.

    Article  Google Scholar 

  • Akhmetova A, et al. A comprehensive review of topical odor-controlling treatment options for chronic wounds. J Wound Ostomy Continence Nurs. 2016;43(6):598–609.

    Article  Google Scholar 

  • Braschi F, et al. Lidocaine controls pain and allows safe wound bed preparation and debridement of digital ulcers in systemic sclerosis: a retrospective study. Clin Rheumatol. 2017;36:209–12.

    Article  Google Scholar 

  • Brink P, et al. Factors associated with pressure ulcers in palliative home care. J Palliat Med. 2006;9(6):1369–75.

    Article  Google Scholar 

  • Carville K, et al. The effectiveness of a twice-daily skin-moisturising regimen for reducing the incidence of skin tears. Int Wound J. 2014;11:446–53.

    Article  Google Scholar 

  • Chadwick P, McCardle J. Exudate management using a gelling fibre dressing. Diabetic Foot J. 2015;18(1):43–8.

    Google Scholar 

  • Cutting KF. Addressing the challenge of wound cleansing in the modern era. Br J Nurs. 2010;19(11):S24–S26-9. (Tissue Viability Supplement)

    Article  Google Scholar 

  • Cutting K, White R. Modern exudate management: a review of wound treatments. Worldwide wounds; 2006 September.

    Google Scholar 

  • Desai C, et al. Sunderland effectiveness of a topical local anaesthetic spray as analgesia for dressing changes: A double-blinded randomised pilot trial comparing an emulsion with an aqueous lidocaine formulation. Burns. 2014;40:106–12.

    Article  Google Scholar 

  • Finlay FG, et al. The effect of topical 0.75% metronidazole gel on malodorous cutaneous ulcers. J Pam Symptom Manage. 1996;11:158–62.

    Article  CAS  Google Scholar 

  • Gosain A, DiPietro LA. Aging and wound healing. World J Surg. 2004;28:321–6.

    Article  Google Scholar 

  • Graham T, et al. How are topical opioids used to manage painful cutaneous lesions in palliative care? A critical review. Pain. 2013;154:1920–8.

    Article  CAS  Google Scholar 

  • Graves ML, Sun V. Providing quality wound care at end of life. J Hosp Palliat Nurs. 2013;15(2):66–74.

    Article  Google Scholar 

  • Greive K. Cleansers and moisturisers: the basics. Wound Practice Res. 2015;23(2):76–81.

    Google Scholar 

  • Grey JE, et al. ABC of wound healing: wound assessment. BMJ. 2006;332(7536):285–8.

    Article  Google Scholar 

  • Harris CL. Chris fraser malnutrition in the institutionalized elderly: the effects on wound healing. Ostomy Wound Manage. 2004;50(10):54–63.

    PubMed  Google Scholar 

  • Haycocks S, Chadwick P. Using an activated charcoal dressing with silver for malodour, infection and overgranulation in diabetic foot ulcers. Diabetic Foot J. 2014;17(2):74–7.

    Google Scholar 

  • Hinman CD, Maibach H. Effect of air exposure and occlusion on experimental human skin wounds. Nature. 1963;200:377–8.

    Article  CAS  Google Scholar 

  • Hopf HW, et al. Guidelines for the treatment of arterial insufficiency ulcers. Wound Repair Regen. 2006;14:693–710.

    Article  Google Scholar 

  • Humphreys ML, et al. Management of mixed arterial and venous leg ulcers. Br J Surg. 2007;94(9):1104–7.

    Article  CAS  Google Scholar 

  • International Wound Infection Institute (IWII). Wound infection in clinical practice. Wounds International. 2016.

    Google Scholar 

  • Kempf M, et al. Cytotoxicity testing of burn wound dressings, ointments and creams: a method using polycarbonate cell culture inserts on a cell culture system. Burns. 2011;37:994–1000.

    Article  Google Scholar 

  • Kuge S, et al. Use of metronidazole gel to control malodor in advanced and recurrent breast cancer. Jpn J Clin Oncol. 1996;26:207–10.

    Article  CAS  Google Scholar 

  • Langemo DK, Black J. Pressure ulcers in individuals receiving palliative care: a national pressure ulcer advisory panel white paper. Adv Skin Wound Care. 2010;23:59–72.

    Article  Google Scholar 

  • Leaper DJ, et al. Extending the TIME concept: what have we learned in the past 10 years? Int Wound J. 2014;9(Suppl. 2):1–19.

    Google Scholar 

  • LeBon B, et al. Effectiveness of topical administration of opioids in palliative care: a systematic review. J Pain Symptom Manag. 2009;37(5):913–7.

    Article  Google Scholar 

  • Leigh IH, Bennett G. Pressure ulcers: prevalence, aetiology and treatment modalities: a review. Am J Surg. 1994;167(1a suppl):25s–30s.

    Article  CAS  Google Scholar 

  • Merz T, et al. Fungating wounds – multidimensional challenge in palliative care. Breast Care. 2011;6:21–4.

    Article  Google Scholar 

  • Mohammed D, et al. Influence of aqueous cream BP on corneocyte size, maturity, skin protease activity, protein content and transepidermal water loss. Br J Dermatol. 2011;164:1304–10.

    Article  CAS  Google Scholar 

  • Peppin JF, et al. Skin matters: a review of topical treatments for chronic pain. Part Two: treatments and applications. Pain Ther. 2015;4:33–50.

    Article  Google Scholar 

  • Probst S, et al. Malignant fungating wounds – The meaning of living in an unbounded body. Eur J Oncol Nurs. 2013;17(1):38–45.

    Article  Google Scholar 

  • Schultz G, et al. Wound bed preparation: a systematic approach to wound management. Wound Repair Regen. 2003;11:1–28.

    Article  Google Scholar 

  • Steele K. Topical treatments for acute and chronic wound pain. J Palliat Med. 2017;20(5):560–1.

    Article  Google Scholar 

  • Sussman G. The wound environment. Aspen: Maryland; 1998.

    Google Scholar 

  • Sussman G. Wound management: part I wound types and the healing process. Australian Doctor. 30 Nov 2001.

    Google Scholar 

  • Sussman G. The impact of medicines on wound healing. Australian Pharm. 2007;26(11):874–8.

    Google Scholar 

  • Sussman G. Ulcer dressings and management. Aust Fam Physician. 2014;43(9):588–92.

    PubMed  Google Scholar 

  • Geoff Sussman. Treating skin tears. Australian Doctor. 14 Oct 2016; 33–5.

    Google Scholar 

  • Sussman G, Golding M. Skin tears: should the emphasis be only their management? Wound Pract Res. 2011;19(2):66–71.

    Google Scholar 

  • Terrill P, et al. Absorption of blood by moist wound healing dressings. Primary Intention. 2003;11(1):7–17.

    Google Scholar 

  • The Alexander House Group. Consensus statement: consensus paper on venous leg ulcers. Phlebology. 1992;7:48–58.

    Article  Google Scholar 

  • Tickle J. Wound exudate assessment and management: a challenge for clinicians. Br J Nurs. 2015;24(20):S38–43.

    Article  Google Scholar 

  • Tsang M, Guy RH. Effect of aqueous cream BP on human stratum corneum in vivo. Br J Dermatol. 2010;163:954–8.

    Article  CAS  Google Scholar 

  • Vowden P, et al. Managing high viscosity exudate. Wounds Int. 2015;6(1):14–8.

    Google Scholar 

  • Weller C, Sussman G. Wound dressings update. J Pharm Pract Res. 2006;36(4):318–24.

    Article  Google Scholar 

  • Wild T, et al. Basics in nutrition and wound healing. Nutrition. 2010;26:862–6.

    Article  Google Scholar 

  • Winter GD. Formation of the scab and the rate of epithelization of superficial wounds in the skin of the young domestic pig. Nature. 1962;193:293–4.

    Article  CAS  Google Scholar 

  • Woo K, et al. Assessment and management of persistent (chronic) and total wound pain. Int Wound J. 2008;5:205–15.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Geoff Sussman .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Sussman, G. (2019). Dealing with a Wound in Palliative Care. In: MacLeod, R., Van den Block, L. (eds) Textbook of Palliative Care. Springer, Cham. https://doi.org/10.1007/978-3-319-77740-5_115

Download citation

Publish with us

Policies and ethics