Palliative Wound Care for Malignant Fungating Wounds: Holistic Considerations at End-of-Life

Timely, holistic interventions aimed at easing the despair of patients with advanced cancer and malignant fungating wounds (MFWs) must incorporate patient and family goals of care in all aspects of decision-making. People with MFWs suffer from a devastating and often crippling symptom burden including disfigurement, pain, pruritus, malodor, exudates, and bleeding. These symptoms may lead to psychosocial and/or spiritual distress, isolation, and diminished quality of life. The complexity of caring for hospice patients with MFWs requires a pragmatic and holistic interdisciplinary approach guided by specialist-level palliative wound care. This article introduces a framework to assist clinicians in the assessment and management of terminally ill patients with MFWs.