Topical agents and dressings for fungating wounds

Abstract

There is weak evidence from one small trial that 6% miltefosine solution applied topically to people with superficial fungating breast lesions (smaller than 1cm) who have received either previous radiotherapy, surgery, hormonal therapy or chemotherapy for their breast cancer, may slow disease progression. There is also weak evidence to suggest that foam dressings containing silver may be effective in reducing malodour. There is insufficient evidence in this review to give a clear direction for practice with regard to improving quality of life or managing wound symptoms associated with fungating wounds. More research is needed.

Malignant fungating wounds assessment in palliative care: a scoping review

“…The publication period of the included studies ranges from 1997 to 2024. The distribution of studies over these years is heterogeneous, with a marked increase in research interest over the past decade ( n = 21, 52.5%) ( 32–52 ). The highest number of eligible studies was published in 2019 ( 34 , 43 , 46 , 50 ), as illustrated in Figure 2 .…”

“…In terms of study design, most of the studies included were primary research ( n = 27, 67.5%), comprising case studies ( n = 8, 20%) ( 33 , 48 , 52–57 ), observational studies ( n = 8, 20%) ( 34 , 36 , 37 , 39 , 41 , 44 , 47 , 58 ), randomized controlled trials ( n = 4, 10%) ( 38 , 42 , 43 , 59 ), clinical trials ( n = 3, 7.5%) ( 49 , 60 , 61 ), mixed-methods research ( n = 2, 5%) ( 62 , 63 ), and validation studies ( n = 2, 5%) ( 46 , 64 ). Secondary research was less common ( n = 13, 32.5%), consisting primarily of systematic reviews ( n = 5, 12.5%) ( 32 , 40 , 45 , 50 , 65 ) and other literature reviews ( n = 8, 20%) ( 35 , 51 , 66–71 ).…”

“…Geographically, the included studies originated from 13 countries in six macro-regions: Europe ( n = 16, 40%) ( 32 , 39 , 40 , 45 , 53–57 , 59 , 60 , 62 , 67–69 , 71 ), East Asia ( n = 9, 22.5%) ( 43 , 47–49 , 51 , 52 , 58 , 61 , 63 ), North America ( n = 6, 15%) ( 36 , 41 , 46 , 64 , 66 , 70 ), South America ( n = 6, 15%) ( 33–35 , 37 , 38 , 65 ), the Pacific ( n = 2, 5%) ( 42 , 50 ), and South Asia ( n = 1, 2.5%) ( 44 ). As shown in Figure 3 , the United Kingdom contributed the largest number of eligible studies ( n = 12, 30%) ( 32 , 45 , 53–57 , 60 , 67–69 , 71 ). Most of the included articles were published in English ( n = 37, 92.5%) ( 32 , 36–46 , 53–62 , 64–70 ), followed by Portuguese ( n = 2, 5%) ( 33 , 34 ), while one record ( n = 1, 2.5%) ( 35 ) appeared in both languages.…”

“…As shown in Figure 3 , the United Kingdom contributed the largest number of eligible studies ( n = 12, 30%) ( 32 , 45 , 53–57 , 60 , 67–69 , 71 ). Most of the included articles were published in English ( n = 37, 92.5%) ( 32 , 36–46 , 53–62 , 64–70 ), followed by Portuguese ( n = 2, 5%) ( 33 , 34 ), while one record ( n = 1, 2.5%) ( 35 ) appeared in both languages.…”

Malignant fungating wounds assessment in palliative care: a scoping review

“…The publication period of the included studies ranges from 1997 to 2024. The distribution of studies over these years is heterogeneous, with a marked increase in research interest over the past decade ( n = 21, 52.5%) ( 32–52 ). The highest number of eligible studies was published in 2019 ( 34 , 43 , 46 , 50 ), as illustrated in Figure 2 .…”

“…In terms of study design, most of the studies included were primary research ( n = 27, 67.5%), comprising case studies ( n = 8, 20%) ( 33 , 48 , 52–57 ), observational studies ( n = 8, 20%) ( 34 , 36 , 37 , 39 , 41 , 44 , 47 , 58 ), randomized controlled trials ( n = 4, 10%) ( 38 , 42 , 43 , 59 ), clinical trials ( n = 3, 7.5%) ( 49 , 60 , 61 ), mixed-methods research ( n = 2, 5%) ( 62 , 63 ), and validation studies ( n = 2, 5%) ( 46 , 64 ). Secondary research was less common ( n = 13, 32.5%), consisting primarily of systematic reviews ( n = 5, 12.5%) ( 32 , 40 , 45 , 50 , 65 ) and other literature reviews ( n = 8, 20%) ( 35 , 51 , 66–71 ).…”

“…Geographically, the included studies originated from 13 countries in six macro-regions: Europe ( n = 16, 40%) ( 32 , 39 , 40 , 45 , 53–57 , 59 , 60 , 62 , 67–69 , 71 ), East Asia ( n = 9, 22.5%) ( 43 , 47–49 , 51 , 52 , 58 , 61 , 63 ), North America ( n = 6, 15%) ( 36 , 41 , 46 , 64 , 66 , 70 ), South America ( n = 6, 15%) ( 33–35 , 37 , 38 , 65 ), the Pacific ( n = 2, 5%) ( 42 , 50 ), and South Asia ( n = 1, 2.5%) ( 44 ). As shown in Figure 3 , the United Kingdom contributed the largest number of eligible studies ( n = 12, 30%) ( 32 , 45 , 53–57 , 60 , 67–69 , 71 ). Most of the included articles were published in English ( n = 37, 92.5%) ( 32 , 36–46 , 53–62 , 64–70 ), followed by Portuguese ( n = 2, 5%) ( 33 , 34 ), while one record ( n = 1, 2.5%) ( 35 ) appeared in both languages.…”

“…As shown in Figure 3 , the United Kingdom contributed the largest number of eligible studies ( n = 12, 30%) ( 32 , 45 , 53–57 , 60 , 67–69 , 71 ). Most of the included articles were published in English ( n = 37, 92.5%) ( 32 , 36–46 , 53–62 , 64–70 ), followed by Portuguese ( n = 2, 5%) ( 33 , 34 ), while one record ( n = 1, 2.5%) ( 35 ) appeared in both languages.…”

Caring for Patients With Malignant Fungating Wounds

“…Most focused on local therapies (dressings), used with or without systemic interventions such as antibiotics. Three studies were case studies32–35 and 3 were reports of original research evaluating the effects of topical or systematic therapies on pain, malodor, exudate, and bleeding 7,36–42…”

Malignant fungating wounds assessment in palliative care: a scoping review

“…The publication period of the included studies ranges from 1997 to 2024. The distribution of studies over these years is heterogeneous, with a marked increase in research interest over the past decade ( n = 21, 52.5%) ( 32–52 ). The highest number of eligible studies was published in 2019 ( 34 , 43 , 46 , 50 ), as illustrated in Figure 2 .…”

“…In terms of study design, most of the studies included were primary research ( n = 27, 67.5%), comprising case studies ( n = 8, 20%) ( 33 , 48 , 52–57 ), observational studies ( n = 8, 20%) ( 34 , 36 , 37 , 39 , 41 , 44 , 47 , 58 ), randomized controlled trials ( n = 4, 10%) ( 38 , 42 , 43 , 59 ), clinical trials ( n = 3, 7.5%) ( 49 , 60 , 61 ), mixed-methods research ( n = 2, 5%) ( 62 , 63 ), and validation studies ( n = 2, 5%) ( 46 , 64 ). Secondary research was less common ( n = 13, 32.5%), consisting primarily of systematic reviews ( n = 5, 12.5%) ( 32 , 40 , 45 , 50 , 65 ) and other literature reviews ( n = 8, 20%) ( 35 , 51 , 66–71 ).…”

“…Geographically, the included studies originated from 13 countries in six macro-regions: Europe ( n = 16, 40%) ( 32 , 39 , 40 , 45 , 53–57 , 59 , 60 , 62 , 67–69 , 71 ), East Asia ( n = 9, 22.5%) ( 43 , 47–49 , 51 , 52 , 58 , 61 , 63 ), North America ( n = 6, 15%) ( 36 , 41 , 46 , 64 , 66 , 70 ), South America ( n = 6, 15%) ( 33–35 , 37 , 38 , 65 ), the Pacific ( n = 2, 5%) ( 42 , 50 ), and South Asia ( n = 1, 2.5%) ( 44 ). As shown in Figure 3 , the United Kingdom contributed the largest number of eligible studies ( n = 12, 30%) ( 32 , 45 , 53–57 , 60 , 67–69 , 71 ). Most of the included articles were published in English ( n = 37, 92.5%) ( 32 , 36–46 , 53–62 , 64–70 ), followed by Portuguese ( n = 2, 5%) ( 33 , 34 ), while one record ( n = 1, 2.5%) ( 35 ) appeared in both languages.…”

“…As shown in Figure 3 , the United Kingdom contributed the largest number of eligible studies ( n = 12, 30%) ( 32 , 45 , 53–57 , 60 , 67–69 , 71 ). Most of the included articles were published in English ( n = 37, 92.5%) ( 32 , 36–46 , 53–62 , 64–70 ), followed by Portuguese ( n = 2, 5%) ( 33 , 34 ), while one record ( n = 1, 2.5%) ( 35 ) appeared in both languages.…”

Caring for Patients With Malignant Fungating Wounds

“…Most focused on local therapies (dressings), used with or without systemic interventions such as antibiotics. Three studies were case studies32–35 and 3 were reports of original research evaluating the effects of topical or systematic therapies on pain, malodor, exudate, and bleeding 7,36–42…”

Malignant fungating wounds assessment in palliative care: a scoping review

“…The publication period of the included studies ranges from 1997 to 2024. The distribution of studies over these years is heterogeneous, with a marked increase in research interest over the past decade ( n = 21, 52.5%) ( 32–52 ). The highest number of eligible studies was published in 2019 ( 34 , 43 , 46 , 50 ), as illustrated in Figure 2 .…”

“…In terms of study design, most of the studies included were primary research ( n = 27, 67.5%), comprising case studies ( n = 8, 20%) ( 33 , 48 , 52–57 ), observational studies ( n = 8, 20%) ( 34 , 36 , 37 , 39 , 41 , 44 , 47 , 58 ), randomized controlled trials ( n = 4, 10%) ( 38 , 42 , 43 , 59 ), clinical trials ( n = 3, 7.5%) ( 49 , 60 , 61 ), mixed-methods research ( n = 2, 5%) ( 62 , 63 ), and validation studies ( n = 2, 5%) ( 46 , 64 ). Secondary research was less common ( n = 13, 32.5%), consisting primarily of systematic reviews ( n = 5, 12.5%) ( 32 , 40 , 45 , 50 , 65 ) and other literature reviews ( n = 8, 20%) ( 35 , 51 , 66–71 ).…”

“…Geographically, the included studies originated from 13 countries in six macro-regions: Europe ( n = 16, 40%) ( 32 , 39 , 40 , 45 , 53–57 , 59 , 60 , 62 , 67–69 , 71 ), East Asia ( n = 9, 22.5%) ( 43 , 47–49 , 51 , 52 , 58 , 61 , 63 ), North America ( n = 6, 15%) ( 36 , 41 , 46 , 64 , 66 , 70 ), South America ( n = 6, 15%) ( 33–35 , 37 , 38 , 65 ), the Pacific ( n = 2, 5%) ( 42 , 50 ), and South Asia ( n = 1, 2.5%) ( 44 ). As shown in Figure 3 , the United Kingdom contributed the largest number of eligible studies ( n = 12, 30%) ( 32 , 45 , 53–57 , 60 , 67–69 , 71 ). Most of the included articles were published in English ( n = 37, 92.5%) ( 32 , 36–46 , 53–62 , 64–70 ), followed by Portuguese ( n = 2, 5%) ( 33 , 34 ), while one record ( n = 1, 2.5%) ( 35 ) appeared in both languages.…”

“…As shown in Figure 3 , the United Kingdom contributed the largest number of eligible studies ( n = 12, 30%) ( 32 , 45 , 53–57 , 60 , 67–69 , 71 ). Most of the included articles were published in English ( n = 37, 92.5%) ( 32 , 36–46 , 53–62 , 64–70 ), followed by Portuguese ( n = 2, 5%) ( 33 , 34 ), while one record ( n = 1, 2.5%) ( 35 ) appeared in both languages.…”

Caring for Patients With Malignant Fungating Wounds

“…Most focused on local therapies (dressings), used with or without systemic interventions such as antibiotics. Three studies were case studies32–35 and 3 were reports of original research evaluating the effects of topical or systematic therapies on pain, malodor, exudate, and bleeding 7,36–42…”