Oncological Wounds Research Articles

Examining the relationship between nutritional status and wound healing in head and neck cancer treatment: A focus on malnutrition and nutrient deficiencies.

The research was conducted to examine the correlation between nutritional status and wound healing in individuals who were receiving treatment for head and neck cancer. Specifically, this study sought to identify crucial nutritional factors that influenced both the recovery process and efficacy of the treatment. From February 2022 to September 2023, this cross-sectional study was undertaken involving 300 patients diagnosed with head and neck cancer who were treated at Tianjin Medical University Cancer Institute and Hospital, Tianjin, China. In order to evaluate nutritional status, body mass index (BMI), serum protein levels and dietary intake records were utilized. The assessment of wound healing was conducted using established oncological wound healing scales, photographic documentation and clinical examinations. After treatment, we observed a noteworthy reduction in both BMI (p < 0.05) and serum albumin levels (p < 0.05). There was slightly increased prevalence of head and neck cancer among males (61.0%, p < 0.05). Over the course of 6 months, significant enhancement in wound healing scores was noted, exhibiting overall improvement of 86% in the healing process. An inverse correlation was identified between nutritional status and wound healing efficacy through multivariate analysis. A logistic regression analysis revealed a significant positive correlation (p < 0.05) between elevated levels of serum protein and total lymphocytes and enhanced wound healing. Conversely, negative correlation (p < 0.05) was observed between larger wound size at baseline and healing. The research findings indicated noteworthy association between malnutrition and impaired wound repair among individuals diagnosed with head and neck cancer. The results underscored the significance of integrating nutritional interventions into therapeutic protocol in order to enhance clinical results. This research study provided significant contributions to the knowledge of intricate nature of head and neck cancer management by advocating for multidisciplinary approach that incorporates nutrition as the critical element of patient care and highlighted the importance of ongoing surveillance and customized dietary approaches in order to optimize wound healing and treatment efficacy.

Use of immunomodulation in cancer wound care: a case study

Skin cancer is characterized by an abnormal proliferation of cells and is considered the most malignant cutaneous tumor, originating from the malignant transformation of melanocytes. The objective of this research was to assess the progression of oncological wounds after six months of specific supplementation aimed at accelerating wound healing. A descriptive analysis of the data obtained during the intervention was conducted, utilizing graphs, tables, and Excel 365 spreadsheets. The immunomodulatory nutritional therapy demonstrated to be of utmost importance, yielding a positive and substantiated enhancement in the wound healing process, providing excellent aesthetic and functional outcomes, and positively impacting the quality of life of the patients.

Cicatrization of Oncological Wounds by Autologous Fibrin Biopolymer Dressing Treatment: A Case Series

Introduction. Traditional therapies used to treat chronic wounds are often expensive and, in general, are not adequate to support healing. A promising alternative to conventional dressings is the autologous biopolymer FM, full of cytokines and growth factors that accelerate the healing process of wounds of various etiologies. Materials and Methods. The authors report 3 cases in which FM was used to treat chronic oncological wounds that had been conventionally treated for more than 6 months with no sign of healing. Results. Among the 3 reported cases, there was complete healing of 2 wounds. The other lesion did not heal, mainly due to the location (at the base of the skull). However, it significantly reduced its area, extension, and depth. No adverse effects or hypertrophic scar formation were recorded, and the patients reported an absence of pain from the second week of FM application. Conclusions. The proposed FM dressing approach was effective in healing and speeding up tissue regeneration. It can also be considered one of the most versatile delivery systems to the wound bed, as it is an excellent carrier of growth factors and leukocytes.

Oncology wounds – recommendations for care based on multidisciplinary cooperation

Oncology wounds and wounds of other etiology are rare but serious complications, which significantly impair patients quality of life. Preventive and curative interventions and education of healthcare personnel and patients reduce the risk of either their occurrence or their impact and consequences. A working group of authors from professional groups (the Supportive Care Group of the Czech Society for Oncology, the Czech Society for Wound Healing, the Society for Radiation Oncology, Biology and Physics, and the Czech Nurses Association) prepared recommendations for care. A comprehensive approach to the treatment of oncological wounds, including symptomatic treatment of associated healing complications, prevention, early detection, interdisciplinary cooperation and education are essential to deal with wounds related to chemotherapy administration, radiotherapy and oncological treatment in general. The proper choice of local care products and the eventuality of active oncological treatment are important elements of care in ulcerating tumors.A basic summary of recommended interventions to prevent and treat oncology wounds in daily practice, defined based on expert societies guidelines, trials and literature data, proven practice and on the consensus opinions of the authors group members. The recommended procedures contribute to the reduction of the development, severity and consequences of oncological wounds and wounds of other etiology in oncological patients.

Oncology wounds - recommendations for care based on multidisciplinary cooperation.

Oncology wounds and wounds of other etiology are rare but serious complications, which significantly impair patients quality of life. Preventive and curative interventions and education of healthcare personnel and patients reduce the risk of either their occurrence or their impact and consequences. A working group of authors from professional groups (the Supportive Care Group of the Czech Society for Oncology, the Czech Society for Wound Healing, the Society for Radiation Oncology, Biology and Physics, and the Czech Nurses Association) prepared recommendations for care. A comprehensive approach to the treatment of oncological wounds, including symptomatic treatment of associated healing complications, prevention, early detection, interdisciplinary cooperation and education are essential to deal with wounds related to chemotherapy administration, radiotherapy and oncological treatment in general. The proper choice of local care products and the eventuality of active oncological treatment are important elements of care in ulcerating tumors. A basic summary of recommended interventions to prevent and treat oncology wounds in daily practice, defined based on expert societies guidelines, trials and literature data, proven practice and on the consensus opinions of the authors group members. The recommended procedures contribute to the reduction of the development, severity and consequences of oncological wounds and wounds of other etiology in oncological patients.

Lesões de pele nos cuidados paliativos oncológicos: Estudo observacional

Objetivo: Descrever as características das lesões de pele do tipo lesão por pressão, ferida tumoral e úlcera terminal de Kennedy que ocorrem nos pacientes oncológicos em cuidados paliativos. Metodologia: Observacional do tipo transversal e analítico com abordagem quantitativa. Participaram 99 (100%) pacientes, portadores de lesões de pele: 67 (67,68%) com lesões tumorais, 28 (28,28%) com lesões por pressão e 4 (4,04%) com úlceras terminais de Kennedy. Foram incluídos os internados em quatro enfermarias e o ambulatório de feridas oncológicas do Hospital Ophir Loyola, no período de maio a novembro de 2019. Resultados: As lesões tumorais se apresentaram com feridas ulcerativas malignas 32 (44,44%), exsudato 50 (69,44%), sem odor 46 (63,89%), não apresentaram necrose 42 (58,33%), sem sangramento 40 (55,56%), estadiamento 3 (31,94%), localização na face (25%), sem utilizar curativo (33,33%) e frequência de curativo 1 vez ao dia 69 (95.83%). Nas Lesões por pressão, as características foram exsudato 22 (56,41%), sem odor 28 (71,79%), necrose 27 (69,23%), sangramento 32 (82,05%), estadiamento II 17 (43,59%), localização sacra 25 (64,10%), utilizando curativo de hidrocolóide 15 (38,46%) e frequência de curativo 1 vez ao dia (64,10%) e as úlceras terminais de Kennedy, exsudato 4 (66,67%), odor grau II 3 (50%), necrose 4 (66,67%), sangramento 4 (66,67%), localização isquiática 3 (50%), forma de pera 3 (50%), utilizando curativo com clorexidina e metronidazol 3 (50%). Conclusão: mostrou-se a importância da avaliação individual conforme as necessidades e as demandas de cada paciente para buscar conforto e qualidade de vida.

Adipose-derived stromal cells for nonhealing wounds: Emerging opportunities and challenges.

Wound healing complications affect thousands of people each year, thus constituting a profound economic and medical burden. Chronic wounds are a highly complex problem that usually affects elderly patients as well as patients with comorbidities such as diabetes, cancer (surgery, radiotherapy/chemotherapy) or autoimmune diseases. Currently available methods of their treatment are not fully effective, so new solutions are constantly being sought. Cell‐based therapies seem to have great potential for use in stimulating wound healing. In recent years, much effort has been focused on characterizing of adipose‐derived mesenchymal stromal cells (AD‐MSCs) and evaluating their clinical use in regenerative medicine and other medical fields. These cells are easily obtained in large amounts from adipose tissue and show a high proregenerative potential, mainly through paracrine activities.In this review, the process of healing acute and nonhealing (chronic) wounds is detailed, with a special attention paid to the wounds of patients with diabetes and cancer. In addition, the methods and technical aspects of AD‐MSCs isolation, culture and transplantation in chronic wounds are described, and the characteristics, genetic stability and role of AD‐MSCs in wound healing are also summarized. The biological properties of AD‐MSCs isolated from subcutaneous and visceral adipose tissue are compared. Additionally, methods to increase their therapeutic potential as well as factors that may affect their biological functions are summarized. Finally, their therapeutic potential in the treatment of diabetic and oncological wounds is also discussed.

Management of an oncological wound: Diagnosis, conflicting therapies and decision-making

This article presents the case of a non-HIV-positive patient who contemporaneously suffered from Kaposi’s sarcoma and bullous pemphigoid. Kaposi’s sarcoma is a rare low-grade vascular tumour associated with human herpes virus 8 infection, while bullous pemphigoid is the most common autoimmune subepidermal blistering disease in western countries.

Wounds in Patients with Cancer

Reconstructive surgery plays an integral role in helping restore form and function in patients with complex oncologic wounds. The intricate process of wound healing can be adversely affected by exposure to chemotherapeutic and radiation therapies. Assessment of available donor tissue quality, previous radiation therapy, vascular status, and donor site morbidity are essential when determining the most appropriate reconstructive approach for definitive wound management. The timing of reconstruction in relation to chemotherapy or radiotherapy regimens influences wound healing. Additionally, the timing of reconstruction is important in order to avoid delaying additional adjuvant therapies. Optimizing nutritional status is critical for improved patient outcomes in the oncologic patient population. At times, palliative efforts by means of surgical debulking are required of a reconstructive surgeon as advanced cancers can leave patients with disfiguring, fungating masses. This review contains 9 figures, and 44 references. Keywords: wounds in cancer, wounds in the cancer patient, oncologic wounds, oncologic wound healing, oncologic wound management, wound complications, effect of chemotherapy on wound healing, effect of radiation therapy on wound healing, oncologic reconstruction

Oncological wounds: meanings and emerging feelings of patients undergoing treatment

Oncological wounds: meanings and emerging feelings of patients undergoing treatment

Total breast reconstruction with fat graft after serial expander deflation: a case series

Fat graft popularity has increased over the last few decades, finding a widespread pattern of application in oncological reconstruction, wound therapy and cosmetic surgery. Recently, the fat graft has been used for breast volume replacement after skin modelling by conventional tissue expanders positioned during mastectomy or after forced removal of prostheses due to complications. Our purpose was to assess fat grafting feasibility and safety, indicating its low rate of complications. We retrospectively analysed 7 patients treated with autologous fat grafts after oncological surgery for breast cancer. Patients not eligible for implant reconstruction and patients who refused implants were included. We analysed age, BMI (Body Mass Index), expansion rate and grafting data (session numbers, injected volume in each session and complication rates). Clinical examinations were performed every 6 months for 1 year after complete reconstruction to evaluate adipose tissue reabsorption and, eventually, further required fat grafting sessions. The aesthetic outcomes were excellent in all of the patients in our series. According to patient surveys, the satisfaction rate was very high. The filled expanders’ final volumes varied from 270 to 630 mL (average: 420 mL). The number of fat grafting sessions ranged between 2 and 3 (average 2.43), and the injected grafting volume during each session varied from 35 to 300 ml (average 175.43 ml). Expander deflation during each surgery session varied from 50 to 270 ml (average 100.63). No complications were reported. Our technique is useful and innovative and leads to good aesthetic results with shorter hospital recovery and low complications rates, compared to major reconstructive surgery. Moreover, the oncological safety appears to be uncompromised. Therapeutic, IV.

Care for the person with oncological wound: permanent education in nursing mediated by educational technologies.

To recognize how educational technologies are not up-to-date and do not care about head and neck oncology. Qualitative, exploratory-descriptive research. Held with 12 nurses, at a cancer reference center in the south of the country, in July/2017. Through a semi-structured interview and data analyzed by Minayo Thematic Analysis. Results of two categories: "The techniques of updating the nurse" and "The use of educational technologies in the nurses' daily life". In this context, a version of the present in the training of students stands out, since the data of secondary education are permanent, evidencing a small use of technological resources for this purpose. It is suggested to integrate the use of technologies with lifelong education in order to become popular in professional practice.

Reality of nurses in the care person with head and neck oncological wound: exploratory study

Objetivo: Conhecer a realidade dos enfermeiros no cuidado de enfermagem à pessoa com ferida oncológica de cabeça e pescoço. Métodos: Estudo exploratório descritivo com abordagem qualitativa. A entrevista semiestruturada ocorreu em julho de 2017 com 12 enfermeiros de um centro de referência oncológica do sul do Brasil. Os dados foram submetidos à análise temática proposta por Minayo. Resultados: Os enfermeiros realizam um cuidado integral com olhar ampliado baseado nos conhecimentos científicos para escolher uma adequada terapêutica no tratamento da ferida. A educação permanente e a existência da equipe especializada facilitam a prática. Já as dificuldades, quando aparecem, envolvem a escolha terapêutica, a continuidade do tratamento domiciliar e o controle dos sintomas da ferida oncológica. Os enfermeiros reconhecem seu trabalho como essencial, gratificante e satisfatório por trazer melhora da qualidade de vida às pessoas. Conclusão: O objetivo do estudo foi alcançado, destacando-se o papel essencial do enfermeiro e os benefícios da educação permanente. Reafirma-se que uma equipe especializada e uma enfermeira estomaterapeuta são fundamentais para a qualidade e resolutividade do cuidado de enfermagem para as feridas oncológicas.

Realidade dos enfermeiros no cuidado da pessoa com ferida oncológica de cabeça e pescoço: estudo exploratório

Objective: To know the reality of nurses in the nursing care for the person with head and neck oncological wound. Methods: Descriptive exploratory study with a qualitative approach. The semi-structured interview occurred in July 2017 with 12 nurses from a cancer reference center in south of Brazil. The data were submitted to the thematic analysis proposed by Minayo. Results: Nurses perform comprehensive care based on scientific knowledge to choose an appropriate therapy in the treatment of the wound. The permanent education and the existence of the specialized team facilitate the practice. The difficulties, when its appear, involve the therapeutic choice, the continuity of the home treatment and the control of the symptoms of the oncological wound. Nurses recognize its work as essential, rewarding and satisfying for bringing improved quality of life to people. Conclusion: The objective of the study was reached, highlighting the essential role of nurses and the benefits of continuing education. It is reaffirmed that a specialized team and a stomatherapist nurse are fundamental for the quality and resolution of nursing care for oncological wounds.

CUIDADOS PALIATIVOS A PACIENTES COM FERIDAS ONCOLÓGICAS EM HOSPITAL UNIVERSITÁRIO: RELATO DE EXPERIÊNCIA

Este estudo tem como objetivo descrever o cuidado desenvolvido no ambulatório de cuidados paliativos, aopaciente portador de ferida oncológica em hospital universitário federal do município de Niterói/RJ, habilitado comoUnidade de Alta Complexidade em Oncologia. Foi desenvolvido por meio da observação das ações de enfermagemna implementação da Política Nacional para Prevenção e Controle do Câncer. A complexidade do cuidado àsferidas oncológicas requer competência técnica e relacional com abordagem às dimensões física, psicológica, sociale espiritual, essenciais para a qualidade de vida do paciente e família. O ambulatório iniciou suas atividades em2005, tendo em outubro de 2014 uma média de 70 pacientes em atendimento e entrada de 12 pacientes novos aomês. Reconhecer os desafios inerentes às tomadas de decisão, nesta proposta de cuidado frente às demandas dopaciente e prover um suporte adequado ao paciente e cuidador são aspectos importantes para um cuidado eficaz.

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.

“R”Shiver me timbers: clinicians doing statistics! A novel approach to data analysis and data visualisation in modern medicine, an example using chronic lymphocytic leukaemia (CLL) data

“R”Shiver me timbers: clinicians doing statistics! A novel approach to data analysis and data visualisation in modern medicine, an example using chronic lymphocytic leukaemia (CLL) data

A computer model of thermal irradiation of the human body for treating surface wounds

Thermal irradiation (TI) is one of the most efficient physical treatments for surface wounds of various etiology (burns, dermatological diseases, oncological wounds, etc.). Computer-controlled directional sources of TI can considerably facilitate efficacy of treatment. Computer control of TI can include mathematical modeling. Computer modeling of TI consists of two parts: the model of the heating device and the model of the human body. The human body model consists of ten segments (30 compartments or three-layer presentations of a segment) which are described by nonlinear equations of the thermal balance of the body. The location of wounds is described in the model by indicating the corresponding compartment. The device is modeled as a system of directional sources of thermal radiation whose radiant flux can be focused anywhere on the surface of the patient's body (including beam movement within a compartment). The TI computer model calculates thermal fluxes received by compartments and thermal exchange between compartments and surroundings and also evaluates common integrated characteristics of the thermal status ~ the body (heat transfer rate, heat content, etc.). The model interface is rather convenient for research purposes.