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Wound Management Guide
Update Sheet
Fungating wounds
Fungating malignant wounds are caused by tumour infiltration of the skin and
its supporting blood and lymph vessels.The tumours may be locally advanced,
metastatic or recurrent.
The tumours are treated by single or combination anti-cancer treatments to
prevent the fungation extending.
Anaerobic bacteria are the source of the malodour and exudate that are
commonly associated with these wounds.
The incidence of fungating wounds is unknown.The loss and disruption to
normal function of large areas of skin, the physical and psychological support
required to meet patients’ needs is significant.
Major Problems
• Odour
• Pain
• Soreness
• Irritation
• Spontaneous bleeding
• Haemorrhage
• Pruritis
• Infection
Treatment
On the whole treatment is palliative rather than curative. Common medical
treatments are hormone manipulation, radiotherapy, and chemotherapy, a
patient may receive one or more of these.
The position of the wound may cause problems in dressing retention and
selection.Many fungating wounds are associated with necrosis, slough and
copious amounts of exudate.
Dressing selection
• Malodour
Metronidazole gel or systemic metronidazole
•
Heavy Exudate
Alginates & absorbent pads
•
Capillary Bleeding
Careful dressing removal & soak off if needed
Alginate dressing
Adrenaline 1 in 1000 to stop bleeding
•
Necrosis and slough
Alginate, amorphous hydrogel or hydrocolloid
Wound Management Guide
April 2002