Key points
- Fungating wounds occur when a malignant tumour spreads into the structure of the skin.
- Management of fungating wounds should take a multidisciplinary approach.
Content:
A fungating wound develops from the extension of a malignant tumour into the structures of the skin, producing a raised or ulcerated necrotic lesion. A breast fungating wound is often an indication that the patient has advanced disease and/or advanced primary breast cancer.
Complications and consequences of a fungating breast/chest wall wound may include:
- Psychological distress
- Stinging, soreness, pain
- Pruritus
- Exudate
- Malodour
- Bleeding
- Infection
Management
Where wound healing is unlikely, the focus of wound management is on comfort, improving quality of life and controlling symptoms. Management of breast / chest wall fungating wounds may include radiotherapy, chemotherapy and endocrine therapy with the aims of reducing the size and symptoms of wounds. As always, the benefits of these treatments must be balanced against their potential side effects.
A multidisciplinary approach to wound management is encouraged, working with palliative care and community services to ensure optimum care. Management will include assessment, the use of medical photography if appropriate (with patient consent) to monitor the condition of the wound management and recommended wound management (for the above complications).
