Microsoft word - 36 management of fungating tumours new aug 2013.doc

Palliative Care Guideline for Management of Fungating Tumours in Adults
A fungat ing tumour is a primary or secondary cancer that has ulcerated the skin. The management of fungatin g tumours focuses on alleviating the distressing symptoms associated with the wound and g emotional support to the patient and family/carers. They most commonly develop from of the head and neck, breast, melanoma and soft tissue sarcoma. Treatment is directed towards, control of bleeding, odour restriction, absorption of exudates, control of pain associated with the lesi on and comfort / cosmetic appearance. This information is a guide and a comprehensive If the wound is moist/dry and clean: the primary dressing should be a non-adherent foam dressing ( semi permeable) e.g. Allevyn/Mepilex Bleeding
Odour Control
Absorption of
Exudates
Pain
Management
Secondary dressings consist of foam dressing +/- additional padding and tubifast to secure For persistent difficult symptoms contact Highland Hospice/PCAS
Emotional Support
The consequences of having a fungating lesion secondary to cancer can be far reaching and encompass physical, psychological, social, sexual and spiritual dimensions. Each patient will react in their own way and a sensitive, skilled approach to care is vital. Patients may experience, depression, embarrassment, social isolation, fear, repulsion, shame, altered body image, and a constant reminder of advanced, incurable disease. Health professionals need to establish trust with patients and family and use tact and sensitivity. There are strategies for managing these psychosocial problems. Interventions should aim to boost patient confidence and improve their ability to socialise wherever possible. • Cosmetic appearance - dressings need to effectively manage odour and exudates but where possible restore body symmetry • Access to counseling services • Appropriate social support to decreases stress and anxiety at home. al care according to individual’s beliefs. • Involve ment of the patient, family and carers in decisions about care. • Open, honest communication of goals and decisions. • Approp riate use of touch / physical contact. Tameside & Glossop NHS Trust and Willow Wood Hospice, Symptom Management Guidelines, 2006 ucestershire PCT Management of Fungating Wounds Guideline, 2007 ww.glospct.nhs.uk/pdf/policies/clinical/cp12dfungatingwounds_jan2007.pdf) NHS Hig hland Wound Management, Guidelines and Formulary 2008 - 2010 Naylor, W. (2002). Part 1. Symptom control: management of fungating wounds. Warning – Document uncontrolled when printed Policy Reference: id1189
Date of Issue: August 2013
Prepared by: Helen MacKenzie, Clinical Lead Nurse, Highland Hospice
Date of Review: August 2015
Lead Reviewer: Dr Jeremy Keen, Consultant, Palliative Care, Highland Hospice
Version: 1
Authorised by: Policies, Procedures and Guidelines Subgroup of ADTC

Source: http://highlandhospice.org/uploads/general/Education%20Resources/36_Management_of_Fungating_Tumours_NEW_Aug_2013.pdf