TITLE

Malignant wound management in breast cancer patient

AUTHOR(S)
Zakaria, Andee Dzulkarnaen; Hassan, Syed; Khan, Amer Hayat; Syed Sulaiman, Syed Azhar; Shaikh, Faiz Ahmed
PUB. DATE
August 2013
SOURCE
HealthMed;2013, Vol. 7 Issue 8, p2496
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Introduction: A malignant wound is usually presents as a discrete non-tender nodule, and often accompanied with malodour. Approximately 62% of malignant wounds will develop in the area of the breast and 24% in the head and neck area. It is estimated that 5-10% of patients with metastases will develop malignant wounds, and they primarily occur in the last 6 months of life. These wounds are not expected to heal unless the pathology is controlled. The wound management is focused on controlling and/or eliminating the distressing symptoms associated with these wounds. Case report: A 40 year old Malay female is presented with left breast lump for 7 months and ulceration accompanied with pain at the swelling for 2 weeks. Chest x-ray findings show a large soft tissue shadow on left breast but no bony lesion. There were ulceration, irregular surface, necrotic area, pus discharge and foul smelling at left breast. Hard swelling was occupying the whole left breast but there was no nipple discharge. Patient is diagnosed with locally advance left breast cancer, T4lMX and is planned for toilet mastectomy. Discussion: Bactigras is used as dressing for the malignant wound on patient's left breast. Bactigras is a low adherent dressing and contains chlorhexidine which is an antimicrobial against a wide range of Gram-positive and Gram-negative bacteria. Activated charcoal and metronidazole powder are used for dressing of the malignant wound in this patient. Activated charcoal is effective in controlling the wound malodour as it attracts and binds to the volatile odour causing molecules, thus preventing their escape from the local wound area. For infected wound with odour, topical metronidazole is used as an antimicrobial dressing to reduce or eliminate the malodour. Conclusion: Although palliative care of the patient with a malignant wound will not cure patients of their advanced cancer, it still serves as an important component to patient as it improves quality of life and eases their pain.
ACCESSION #
89987198

 

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