An algorithm-for local non-surgical management of complicated wounds in head and neck cancer patients

This review paper introduces an algorithm for non-surgical local wound care in head and neck cancer patients who have delayed and complicated wound healing. Wound complications are common in patients undergoing head and neck cancer treatment, regardless of whether their primary treatment modality is surgery or chemoradiation. The risk for complications is compounded by the vital structures in the regional anatomy of these tumors and by the toxicities and long-term consequences of the cancer treatments employed. There is limited empirical and clinical evidence to specifically guide and improve local wound healing outcomes in head and neck cancer patients. The algorithm, based on an analysis of the medical literature, begins with the assessment of five simple wound environment characteristics: exudate volume; slough and eschar; large vessel exposure; proliferation; and systemic nutrition and perfusion. Assessing these wound characteristics is the basis for planning local care. The wound characteristics are discussed in relation to the pertinent literature, product categories, and other known interventions presented herein.