Quality of life in patients with malignant wounds treated at a wound care clinic.

Abstract

e24075 Background: Malignant wounds can present in up to 14.5% of patients with advanced cancer, significantly reducing quality of life (QoL). Patients with chronic leg ulcers experienced improved QoL, as determined by a reduction in Skindex-16 score after treatment at a dedicated wound care clinic. We sought to assess the effect of wound care clinics on QoL in patients with malignant wounds. Objectives: To describe the baseline QoL, physical symptoms, and treatment modalities that affect QoL in patients with malignant wounds. To assess changes in QoL over time of patients attending a wound care clinic. Methods: This retrospective study included 36 patients seen from 1/1/2016 - 4/1/2023 at a wound care clinic at an oncologic hospital with at least one completed Skindex-16 questionnaire, which is a validated measure of the effects of skin diseases on QoL. Data were extracted from the electronic medical record. Descriptive statistics, graphical methods, and random effects models for change were used to describe the patient population and the QoL measures over time. Results: Of the 36 patients who completed at least one Skindex-16 questionnaire, 69% were female, and 50% developed malignant wounds from metastatic breast cancer, 22.2% from cutaneous squamous cell carcinoma, and 27.8% from various malignancies such as sarcoma. Most patients had advanced cancer; 9.7% were stage II, 41.9% stage III, and 48.4% stage IV. At the initial visit, patients had drainage associated with their wound 86.1% of the time, odor 47.2%, bleeding 63.9%, pain 69.4%, and itch 50% of the time. Patients were treated with dressings 100% of the time, and 88.2% of patients received topical treatment for odor, 73.9% received topical treatment for bleeding, 55.6% topical itch treatment, 44% topical pain treatment, 36% gabapentin, and 24% received an opioid. The median baseline Skindex-16 score was 59.5, falling into the “extremely severe” category, with a median score of 17.5, 21, and 23 for the symptom, emotion, and function domains, respectively. Nineteen patients completed an additional Skindex-16 questionnaire at follow up visits (visit two 52.8%, visit three 33.3%, visit four 19.4%, visit five or greater 13.9%). Compared to the median Skindex-16 score at baseline, there was a 34.5% improvement at visit two, 45.4% at visit three, 73.1% at visit four, and 83.2% improvement in QoL at visit five or more. Conclusions: Malignant wounds severely reduce patients’ quality of life; however, patients experienced significantly improved quality of life after being treated at dedicated wound clinics.