Wound Management in Oncology Patients

Wound ManagementWound healing is a matter of great concern among oncology patients. As the cancer treatment strategies currently include surgery, radiation, and chemotherapeutic regimens, wounds created by these strategies can lead to a lot of problems. Even a simple wound can move down to the bone and cause a bone infection, making it difficult to heal. With wounds getting more common, it is crucial for oncology nurses to perform frequent wound assessment, monitor the progress of wound healing, and most importantly, ensure that they help patients learn to care for them on their own.

  • Radiotherapy is often considered before surgery to treat undisturbed tissues and to minimize the tumor size or after surgery to attack cancer cells that may have disseminated beyond the surgical margins. However, as this therapy cannot differentiate between normal cells and cancer cells, normal cells within the path of the radiation beam may be affected, causing the patient to experience side-effects.
  • Chemotherapy is offered to enable normal cells to recover while killing a number of malignant cells with each administration. But by inhibiting cell division and protein synthesis, chemotherapy can adversely affect wound healing. Skin reactions associated with chemotherapy include transient erythema, hyperpigmentation, photosensitivity, nail changes and palmar/plantar syndrome. Many chemotherapy drugs can also cause immunosuppression.
  • Unlike in older days, today surgery tends to be more conservative, such as a lumpectomy followed by further treatment such as radiotherapy. However, radical surgery may cause major deformities to the individual as well as loss of function. This can also have major psychological implications for the patient, resulting in depression.
  • Reconstructive surgery is carried out with the initial surgery for tumor removal, or following a period of time. Side effects of surgical treatments may result in complex wounds that require a well-planned management strategy. Wound-related complications of surgery include hemorrhage and hematoma, sepsis, pulmonary complications, and thrombophlebitis.

In order to reduce the risk of cancer wound complications, careful and continuous assessment should be carried out on each individual wound. For further treatment, it is highly important that the wound assessment includes all the details related to the wound such as whether the wound is caused by radiotherapy or whether it is a fungating wound, location, size, depth and shape of wound, amount and nature of exudates, odor present, type of tissue present, signs of infection, and conditions of surrounding skin.

Wound management includes irrigation of the wound as well as dressing application. Documenting the assessment and treatment details using efficient wound EMR software allows caregivers to quickly access patient data and to identify pertinent information. Advanced EMR solutions come with separate interface for nurses and physicians where they can enter patient data and observations at every stage.