Treating Fungating Breast Cancer Wounds with Polymeric Membrane Dressings, an Innovation in Fungating Wound Management
Problem: Breast cancer is the most common form of malignancy affecting women worldwide. It is also the leading cancer in females in Cyprus, with approximately 400 new cases diagnosed annually. Women with fungating breast cancer wounds experience problems with exudate management, discharge, odour, pain, bleeding, and itching. Treatment of fungating wounds is often symptomatic and very traumatic for the patient. Year 2000 I started to use polymeric membrane dressings (PMDs) on these wounds with remarkable outcomes. I wanted to examine the effect of PMDs in alleviating the symptoms associated with fungating wounds and present my experience with PMDs.
Methods: 25 women with breast cancer wounds have been treated with this method so far. 15 women were unfit for surgery and 10 women refused surgery. Primary endocrine therapy was offered to 20 women with oestrogen receptor (ER)-positive breast cancer. Most wounds were open for three months before they were referred to us. All patients had problems with irritated periwound area and itching. Only two patients needed sharp debridement, the rest were debrided with PMDs.
Results: PMDs managed to maintain an optimal moisture balance and we had no problems with the periwound area. PMDs helped reduce the problems the women experienced with fungating tumors. PMDs eliminated the need of painful cleansing during dressing changes. Five of our wounds actually healed but three of these reopened after 6 months. Our intervention succeeded in increasing breast cancer patients’ psychosocial wellbeing and reduce social isolation.
Conclusions: A thorough understanding of the use PMD in the management of breast cancer wounds will assist the practitioner in alleviating the symptoms and minimizing emotional distress in elderly patients. Though the goal is not to heal these wounds we have found most of the wounds improve when being treated with PMDs.
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