Book contents
- Frontmatter
- Contents
- List of contributors
- Preface
- Acknowledgements
- PART I General concepts in oncology
- Part II Primary tumors
- Part III Management of specific symptoms and syndromes
- 41 Assessment of pain
- 42 Drugs for managing cancer pain
- 43 Difficult pain management problems
- 44 Dyspnea
- 45 Loss of appetite and weight
- 46 Fatigue
- 47 Depression and anxiety
- 48 Delirium
- 49 Constipation
- 50 Palliation of fever and sweats: the heat is on!
- 51 Bleeding in advanced cancer patients
- 52 Thrombosis
- 53 Hypercalcemia of malignancy
- 54 Lymphedema
- 55 Wound care of the advanced cancer patient
- 56 Infections in patients with advanced cancer
- 57 Urogenital complications
- 58 Brain metastases
- 59 Bowel obstruction
- 60 Bone metastases
- 61 Meningeal cancer
- 62 Pleural and pericardial effusions
- 63 Superior vena cava syndrome
- 64 Chronic nausea
- Index
- References
55 - Wound care of the advanced cancer patient
Published online by Cambridge University Press: 04 August 2010
- Frontmatter
- Contents
- List of contributors
- Preface
- Acknowledgements
- PART I General concepts in oncology
- Part II Primary tumors
- Part III Management of specific symptoms and syndromes
- 41 Assessment of pain
- 42 Drugs for managing cancer pain
- 43 Difficult pain management problems
- 44 Dyspnea
- 45 Loss of appetite and weight
- 46 Fatigue
- 47 Depression and anxiety
- 48 Delirium
- 49 Constipation
- 50 Palliation of fever and sweats: the heat is on!
- 51 Bleeding in advanced cancer patients
- 52 Thrombosis
- 53 Hypercalcemia of malignancy
- 54 Lymphedema
- 55 Wound care of the advanced cancer patient
- 56 Infections in patients with advanced cancer
- 57 Urogenital complications
- 58 Brain metastases
- 59 Bowel obstruction
- 60 Bone metastases
- 61 Meningeal cancer
- 62 Pleural and pericardial effusions
- 63 Superior vena cava syndrome
- 64 Chronic nausea
- Index
- References
Summary
Introduction
Pressure ulcers, surgical wounds, malignant cutaneous wounds, radiation therapy-induced skin alterations, and incontinence-induced wounds are commonly experienced by cancer patients.
Assessment
Wound assessment and documentation should include the following findings:
Degree of tissue layer destruction or color.
Anatomic location.
Length, width, depth, and tunneling using consistent units of measure.
Appearance of the wound bed and surrounding skin.
Drainage, specifying amount, color, and consistency.
Pain or tenderness.
Temperature (Hess 1999).
These parameters were developed to assess pressure ulcers, but they are useful guidelines for assessing other types of wounds.
The skin surrounding the wound must be assessed for color, temperature, and swelling. The wound's epithelial edge is assessed for continuity and integrity. Excessive dryness or moisture or the presence of nonviable tissue or exudate may delay re-epithelialization once granulation occurs. Finally, assess the wound for the presence of foreign objects such as sutures, staples, or environmental debris (Hess 1999).
Urinary or fecal incontinence
Skin-related damage may appear as an irritant contact dermatitis, involving erythema, edema, and vesicle formation. Failure to remove the irritant (urine or stool) will result in progressive inflammation of the skin, resulting in blistering, erosion of epidermis, weeping, and pain. Itching and burning occur with mild inflammation, whereas severe inflammation is associated with epidermal loss and exposure of dermal nerve endings, causing pain. Candida albicans yeast infection commonly causes a rash in these patients.
Prognosis and treatment
Topical wound management is designed to keep the wound moist, clean, warm, and protected from trauma and secondary infection.
- Type
- Chapter
- Information
- Handbook of Advanced Cancer Care , pp. 439 - 443Publisher: Cambridge University PressPrint publication year: 2003