Neoplastic Wounds Research Articles

ENFERMAGEM NO CUIDADO DE PACIENTES COM FERIDAS NEOPLÁSICAS

Introduction: This study addresses the role of nursing in caring for patients with neoplastic wounds, highlighting the importance of a comprehensive and specialized approach. Neoplastic wounds are complex lesions associated with neoplasms that significantly impact patients’ quality of life, requiring careful management by the nursing team. Objective: To conduct an integrative literature review to analyze nursing practices in the management of neoplastic wounds, identifying challenges, knowledge gaps, and directions for improving practices. Methodology: An integrative literature review with a qualitative approach was conducted, using databases such as BVS, PubMed, and SciELO. The included articles were published between 2018 and 2023 and focused on the nursing role in caring for neoplastic wounds. Exclusion criteria included incomplete or restricted-access articles. Results: The analysis of the studies revealed that, despite technological advances in wound treatment, such as the use of modern dressings, knowledge gaps remain among nurses regarding neoplastic wounds. Effective management of these lesions requires not only technical expertise but also a multidisciplinary approach, focusing on pain, odor control, and emotional support. Conclusion: Nursing plays a central role in the care of patients with neoplastic wounds, making ongoing training and the development of educational programs essential. This study emphasizes the need for holistic and humanized care, aimed at improving both the physical and emotional aspects of the patient.

Palliative care for people with neoplastic wounds: perceptions and practices of the nursing team

Objective: To understand the perceptions and practices of the nursing team in assisting people in palliative care with neoplastic wounds. Method: A descriptive study with a qualitative approach, carried out with 12 nursing professionals working in a Level II High Complexity Oncology Hospital, located in the interior of Minas Gerais, Brazil, in 2022. Data was collected through semi-structured interviews and analyzed according to the method proposed by Bardin. Results: Three thematic categories emerged: Nursing care that transcends the management of neoplastic wounds; The role of the nursing team in the assessment and care of neoplastic wounds; and Feelings that involve nursing professionals in the context of palliative care. Conclusion: It is essential to approach the person holistically. The management of neoplastic wounds has its own particularities, since pain is a symptom that usually accompanies the lesion, in addition to the odor and discomfort that the person and their family may feel. Palliative care is relevant to help manage the symptoms of these lesions. Workers often experience feelings such as anguish, fear, sadness and frustration.

CONSTRUCTION OF AN ALGORITHM OF CONDUCT OF SIGNS AND SYMPTOMS IN MALIGNANT NEOPLASTIC WOUNDS IN ADULTS

Objective: To build an algorithm of conducts to control signs and symptoms of malignant neoplastic wounds in adults. Method: Methodological research, of an exploratory nature, for the construction-production of a clinical algorithm based on the scoping review. Results: A total of 107 studies was found in the databases, nine of which were included in this review. Four studies are randomized experimental studies, four are case studies and one is retrospective documentary observational study. Odor was the most addressed sign, followed by exudate, bleeding, infection, moisture-associated dermatitis, and pain. Conclusion: Gaps were observed, such as the need for more original and experimental studies, in addition to the lack of a specific descriptor for malignant neoplastic wound. However, it was possible to build an algorithm that offers conducts that are based on the literature for greater theoretical support and nursing safety in relation to cancer patients.

CONSTRUÇÃO E VALIDAÇÃO DE UM INSTRUMENTO SOBRE MANEJO DE FERIDA NEOPLÁSICA PARA CAPACITAÇÃO DE ENFERMEIROS

ABSTRACT Objective: to create and validate the face and content of an instrument for training nurses in neoplastic wound care. Method: a methodological research study with a quantitative approach, carried out in three stages: scoping review; creation of the instrument; and face and content validation. Data collection took place between October 2021 and February 2022 in Niterói - RJ - Brazil. The Content Validation Index and Fleiss Generalized Kappa were used. Results: the final instrument consists of the following phases: definition of neoplastic wound; wound classification; staging; pain and odor rating scales; Nursing care; and management of signs and symptoms. The content was validated reaching a Content Validation Index > 0.80 and an agreement level between the judges > 75%, as established. Conclusion: validation of the instrument will contribute to reducing the gap indicated in the literature on Nursing care in relation to neoplastic wounds, in addition to its application to Nursing teaching and services.

CARE OF FAMILY MEMBERS OF PEOPLE WITH MALIGNANT NEOPLASTIC WOUNDS AT HOME

Objectives: To understand how caregivers of people with malignant neoplastic wounds perform care at home. Method: A qualitative study that involved seven relatives of people with malignant wounds undergoing treatment in a high complexity oncology unit. The data were produced through semistructured interviews and submitted to thematic content analysis, proposed by Bardin. Results: Seven family-caregivers, all female, young people who left work to dedicate themselves to the sick person were interviewed. Three categories emerged after content analysis: family members seek guidance to care for patients with malignant neoplastic wounds at home; they adopt strategies in wound care; and report the need for support from health professionals and institutions, because they face difficulties in care, especially in primary care units. Conclusion: Family members of people with malignant neoplastic wounds face difficulties, mainly due to the scarcity of technical knowledge and lack of support from health institutions and from professionals.

Understanding and caring for patients with smelly wounds

Some wounds, particularly chronic, infected and neoplastic wounds, in addition to causing pain, damage the person's self-image, particularly when they are malodorous. For the patient himself, for their relatives and for the professionals responsible for their care, these malodorous wounds penalise the relationship and even the care. They are a source of isolation and can have severe effects on the patient. However, solutions do exist.

Perfil bacteriológico e variáveis da ferida neoplásica em pacientes em cuidados paliativos: estudo transversal

Objetivo: verificar a associação entre perfil bacteriológico e variáveis relacionadas às feridas neoplásicas dos pacientes sob cuidados paliativos. Método: Estudo transversal, com amostra composta por 36 pacientes internados nas enfermarias do Instituto Nacional do Câncer José Alencar Gomes da Silva – Unidade IV. A coleta de dados ocorreu entre os meses de outubro e dezembro de 2018, sendo utilizado um formulário próprio. Na análise dos dados utilizaram-se medidas descritivas e teste de Fischer/qui-quadrado ao nível de significância de 5% (α = 0,05). Resultados: A amostra foi composta por 36 indivíduos, sendo 19 (52,78%) do sexo feminino, com percentual predominante de formação de metástases (63,89%). Há forte associação entre as variáveis radioterapia paliativa e a presença de Pseudomonas sp. (p = 0,02), tipo de tumor primário e a presença de Citrobacter sp. e Acinetobacter sp. (p < 0,001) e localização da ferida neoplásica a presença de Citrobacter sp. (p = 0,03) e Acinetobacter sp. (p = 0,01). A não utilização de antibiótico não favorece o aumento do biofilme na ferida neoplásica. A quimioterapia paliativa não se associa a nenhum gênero bacteriano. As principais bactérias identificadas foram Pseudômonas sp., Morganella sp., Klebsiella sp. e Proteus sp.. Conclusão: o tratamento com radioterapia, o tipo de tumor primário e local da ferida tumoral apresentam associação significativa com o perfil bacteriológico das lesões e, portanto, recomenda-se a coleta de swab e análise de antibiograma das feridas neoplásicas para aprimorar a assistência de enfermagem.

Perfil sociodemográfico, clínico e terapêutico de pacientes com feridas neoplásicas

Objetiva-se traçar o perfil sociodemográfico, clínico e terapêutico de pacientes com feridas neoplásicas atendidosem um hospital referência de Campina Grande-PB. Trata-se de um estudo documental, retrospectivo e descritivo, comabordagem quantitativa, em que foram utilizados dados secundários – sociodemográficos, clínicos e terapêuticos -extraídos de prontuários de pacientes com feridas neoplásicas, no intervalo de janeiro de 2009 a dezembro de 2015.A amostra foi composta por 852 prontuários, destes, 447 eram mulheres (53%), com idade igual ou maior que 60 anos(58,2%), casadas (28,6%), sem escolaridade (28,5%), agricultoras (23,9%) e aposentadas (36,3%). A maioria (50,6%)foi diagnosticada com câncer de pele, as lesões apresentavam dor (9,6%), sangramento (3,9%), odor (2,5%), exsudato(2,0%) e sinais de infecção (1,1%). Quanto à modalidade terapêutica, a maioria (50,7%) dos pacientes realizoubiópsia, seguida de radioterapia (42,2%). Conclui-se que faz-se necessário implementar políticas públicas no tocanteà prevenção dos cânceres de pele, boca e mama, a fim de diminuir o risco para adoecimento; educação em saúdepara esses pacientes, como também reduzir complicações locais e sistêmicas, tais como as lesões neoplásicas; ecriar estratégias efetivas para o registro das informações sociodemográficas, clínicas e terapêuticas completas dopaciente em prontuários eletrônicos ou convencionais pelos profissionais de saúde.Palavras-chave: Neoplasias Cutâneas; Oncologia; Cuidados de Enfermagem.

Sentimentos de enfermeiras no cuidado de pessoas com feridas neoplásicas

O objetivo é compreender os sentimentos de enfermeiras no cuidado de pessoas com feridas neoplásicas durante arealização do curativo. Trata-se de um estudo exploratório, de natureza qualitativa, realizado com 20 enfermeirasassistenciais de um hospital filantrópico da Paraíba que presta cuidados a pacientes com doença oncológica avançada.Os dados foram coletados no período de abril a junho de 2016, por meio de entrevistas norteadas por um roteirosemiestruturado, após aprovação do Comitê de Ética em Pesquisa do Hospital Universitário Alcides Carneiro sob parecern.º 1.320.367 e analisadas por meio da Técnica de Análise do Conteúdo de Bardin. Os discursos apontaram sentimentospositivos e negativos, percebidos durante a realização dos curativos, onde o sentimento tristeza obteve o maiorpercentual de respostas. Evidenciou-se que as enfermeiras desenvolvem habilidades empáticas diante do sofrimento dopaciente, promovendo ações de solicitude com vistas ao conforto físico e psíquico do mesmo.Palavras-chave: Oncologia; Enfermagem Oncológica; Neoplasias Cutâneas.
 AbstractThe aim is to understand the nurses’ feelings in the care of people with neoplastic wounds during the dressing. This is anexploratory qualitative study carried out with 20 nursing assistants from a philanthropic hospital in Paraíba that providescare to patients with advanced cancer disease. The data were collected from April to June 2016, through interviewsguided by a semi-structured script, after approval of the Research Ethics Committee of the Alcides Carneiro UniversityHospital under opinion No. 1,320,367 and analyzed by means of the Technique of Bardin Content Analysis. The speechespointed to positive and negative feelings, perceived during the dressings accomplishment, where the sad feeling obtainedthe highest percentage of responses. It was evidenced that the nurses develop empathic abilities in the face of thepatient's suffering, promoting solicitude actions with a view to the physical and psychic comfort of the same.Keywords: Oncology; Oncological Nursing; Cutaneous Neoplasms

Odor evaluation scales for odor in neoplastic wounds: an integrative review.

Checking for the existence of assessment instruments for odor in neoplastic wounds. Integrative review performed in the databases Lilacs, SCiELO, Ibecs and MedLine, including national and international publications. 15 articles were analyzed, in its majority performed by nurses and being of the revision type. Nine scales were found, of which the majority assesses only the odor intensity. The scale most used to evaluate products and/or bandage covers for neoplastic injuries was the Odor Evaluation Guideline, of qualitative-quantitative nature, that establishes the symptom within four levels; only one of which being validated (Teler scale). The results of this study showed that, currently, there is only one scale that is validated for assessing odor in neoplastic wounds, pointing towards the need to develop new instruments that incorporate validated and reliable instruments in clinical practice.

Odor evaluation scales for neoplastic wounds: an integrating review

Introduction: Cancer is a public health problem, and among patients with neoplasias, 5 to 10% will develop disease-related wounds where they affect the quality of life of the patient. Odor is the most prevalent symptomatology and requires frequent assessment to identify appropriate conduct and necessary adjustments. Objective: To verify the existence of odor evaluation instruments in neoplastic wounds. Methodology: This is an integrative review of the literature. The bibliographical survey was performed from September to October 2016 in the databases Lilacs, SciELO, IBECS and MEDLINE, with no time limit. Original articles were included in Portuguese, Spanish and English, published in full and electronically available, totaling 15 articles. Results and Discussion: Among the symptoms of neoplastic wounds, bad odor is one of the most complex to address and should be explored carefully and scientifically, for decision-making and interventions. In this research were found only scales and no instrument. Nine assessment scales were found, most of them produced by nurses, who evaluated only the intensity of the odor, and only two evaluated the distance and intensity. The most used scale was the qualitative and quantitative odor evaluation guide, designed to evaluate products and / or coverings in neoplastic wound dressings, scoring the symptom in four levels. As for validation, only the Teler scale was validated, scoring on six levels. Therefore, even in the absence of validity, the scales have been used in clinical practice, both in verifying the efficacy of the treatment for odor control and in the measurement of the symptom itself. Conclusion: The results of this study have demonstrated to date a single validated scale, pointing to the need to develop new tools in order to incorporate validated and reliable instruments into clinical practice.

Conhecimento e prática de enfermeiros no controle de feridas neoplásicas

O objetivo deste estudo foi verifi car o conhecimento e prática de enfermeiros no controle de sintomas de pacientescom feridas neoplásicas. Trata-se de um estudo descritivo de desenho quantitativo realizado com 22 enfermeirosde um hospital fi lantrópico de Campina Grande – PB durante o período de abril a junho de 2016. O instrumentofoi um questionário estruturado, contendo questões relativas ao controle do sangramento, exsudato, odor, necrosee fístula das feridas neoplásicas. Os resultados obtidos nesta pesquisa permitiram identifi car que os enfermeirosapresentam lacunas no conhecimento de conteúdos e técnicas sobre avaliação e tratamento de pacientes comferidas neoplásicas. Além disso, constatou-se que os enfermeiros não executam alguns cuidados pertinentes a essaclientela. Desse modo, conclui-se que a instituição precisa investir em educação permanente, a fi m de treinar aequipe de enfermagem para o acompanhamento de pacientes com lesões neoplásicas, adquirir materiais necessáriose implantar protocolos assistenciais que norteiem a prática de métodos avaliativos e terapêuticos para o cuidadocom pessoas com feridas neoplásicas, familiares e cuidadores.

Knowledge of nursing students about the care provided to people with neoplastic wounds

Objective: To investigate the knowledge of nursing students about the care provided to patients with neoplastic wound.
 Method: This is an exploratory research of a qualitative nature, which was attended by 15 students of the Bachelor's Degree in Nursing from the Center of Education and Health of the Federal University of Campina Grande, campus Cuité - PB, in the period from October to November 2015. For data collection, we used a form for an interview. The data were analyzed through the Technique of Thematic Analysis of Minayo.
 Results: From the analysis of the empirical material emerged the following thematic categories: Category 1 - Defining neoplastic wounds; Category 2 - Knowledge incipient on ‘neoplastic wounds’ for academic and professional practice; Category 3 - Envisioning the theme "neoplastic wound" in the Academy; Category 4 - Knowledge about methods of evaluation of neoplastic wounds and Category 5 - Knowledge of therapeutic modalities of neoplastic wounds.
 Conclusions: The academics know the evaluative method of a patient with neoplastic wound as integralizadora unit of care process; recognize palliative care as the best therapeutic modality for these customers, especially when they are in completion and indicate the products contraindicated in the treatment of these lesions; however, do not mention the covers and recommended substances for the control of the signs and symptoms of these injuries. In this context, it is believed that the creation of academic projects of extension, with the aim of creating opportunities for integration between theory and practice, is one of the ways to improve the knowledge.
 
 Keywords: Knowledge; Students of Nursing; Skin Neoplasms.

Neoplastic wounds: controlling pain, exudate, odor and bleeding

Objective: To synthesize scientific literature published on the control of pain, exudation, odor and bleeding of neoplastic wounds.
 Methods: This is an integrative review of the literature in the databases CINAHL, SciELO, MEDLINE and LILACS with articles that approached the theme. Twenty-two articles were included, of which 18 were written in the English language and three in the Spanish language, published between 2004 and 2014.
 Results: From the articles studied, categories were constructed: Interventions for pain control; Interventions for the control of exudate; Interventions for the control of odor and Interventions for the control of bleeding.
 Conclusion: Most of the studies were bibliographical research originating from opinions of authorities and / or reports of committees of experts in the area. Therefore, it is urgent to carry out randomized clinical trials.
 
 Keywords: Cutaneous ulcer; Injuries and injuries; Nursing oncology; Nursing care.

Malignant Neoplastic Wounds: Clinical Management Performed by Nurses

Objective: Investigate the clinical management of patients with neoplastic wounds by nurses. Methods: This is an exploratory study, with qualitative approach, conducted in August 2014, with ten clinical nurses of a philanthropic hospital that provides care to patients with advanced cancer. Data were collected through semi-structured interviews and data analysis was performed using the Minayo’s Thematic Analysis Technique, which enabled the construction of one category and four subcategories. Results: The nurses’ knowledge on the clinical management of wounds is weak and has many weaknesses involving patients with advanced cancer. Conclusion: One evidenced the need to invest in continuing education and implementation of protocols that support greater autonomy of nurses in decision-making, ensuring legal support to these professionals to improve care for people with neoplastic wounds. Key words: Skin Ulcer; Wounds and Injuries; Oncology Nursing; Nursing Care.

Heridas neoplásicas: Aspectos básicos del cuidado de enfermería

Neoplastic wounds are related to the tumor and require a special and more careful approach for the different factors associated with cancer. Problems of difficult handling can be found such as bad odor, exudate, bleeding, pain, infection, visual appearance that causes low self-esteem and social isolation that leads to a marked deterioration in the quality of life of patients and their families. Objective: to determine what are the basic aspects of nursing care in neoplastic wounds. Materials and methods: this documentary review analyzes the epidemiology, classification, assessment instruments and current care interventions that the nursing professional should have when providing care to these patients. Conclusion: a multidisciplinary team is required for the management of neoplastic wounds. The problems or needs must be identified, according to this a personalized management plan will be designed and the interventions will be evaluated, generating a positive impact on the current and future lifestyle of the patient.

Occurrence and management of neoplastic wounds in women with advanced breast cancer

Objective: To characterize the socio-demographic profile of women with breast cancer who present neoplastic wounds, and to identify the dressings used most for treating these wounds. Methods: This study has a quantitative approach, is cross-sectional and retrospective. The data was collected through a review of hospital records of women with breast cancer in the period 2000-2011. Results: The sample was constituted of 62 women with a mean age of 55.4 years old; 75.8% were white, 55% had invasive ductal carcinoma and 27.4% were in clinical stage IIIb. Of the deaths recorded, 27% occurred in less than 1 year after the appearance of the wound. The symptoms recorded were pain (32.2%), bleeding (35%) and necrosis (21%). The products used were silver sulfadiazine (23%) and Essential Fatty Acid (EFA) (16.1%). Conclusion: The results point to a lack of systematization of nursing care related to oncological wounds in this service.

Neoplastic wounds and degenerescence

Between 5% and 10% of cancer patients develop malignant wounds. Cancer wounds can occur as a clinical entity, especially over the breast, with the development of painful, spreading cancer invasions of the skin.Marjolin's ulcers develop in open wounds after a long period, and form rare malignancies arising from previously traumatised, chronically inflamed, or scarred skin. Marjolin's ulcer is associated with malignant transformation of chronic ulcers, sinus tracts, and burn scars. Squamous cell carcinoma may be linked to a wide variety of medical and surgical clinical situations, such as chronic ulcers, sinuses, chronic osteomyelitis, radiotherapy, burn scars, chronic pressure ulcers, as well as cystostomy sites, and Fournier's gangrene scars. Melanomas, lymphomas, and other cancers can also be observed. Basal cell carcinoma is more frequently observed in ulcers associated with venous insufficiency. According to some reports, the ulcer should have existed for at least 3 years to evoke a diagnosis of degenerescence as opposed ulcerated tumour. Epidermoid carcinomas represent between 0.21% and 0.34% of cancers that develop over leg ulcers, but large series are still lacking. The current lack of epidemiological data could be rectified by more frequent evocation of the diagnosis and a policy of systematic biopsy of chronically open wounds.