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Improving Quality of Life in Patients with Malignant Wounds: Outcomes from a Specialized Wound Care Clinic
Ian Nykaza1,2, Anna Chen1, Stephen Dusza1
1Department of Medicine, Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
Abstract:
Objective: Evaluate quality of life (QoL) of patients with malignant wounds at baseline and through the course of management at a dedicated malignant wound care clinic. Methods: Retrospective review of patients with malignant wounds seen at a dedicated wound care clinic between January 2016 and April 2023 who completed the Skindex-16, a validated dermatologic QoL questionnaire. Clinical symptoms and management data were extracted from electronic medical records. Results: At baseline, patients reported high Skindex-16 scores across symptoms (mean = 64.2, standard deviation [SD] = 33.3), emotions (mean = 44.8, SD = 31.2), and functioning (mean = 67.7, SD = 29.7) domains. Overall Skindex-16 scores significantly improved over time, with a mean reduction of 4.9 points per visit (p = 0.002). Multimodal symptom management, including both topical and systemic treatments, and modern dressings were commonly utilized. Clinical Implications: Early referral to specialized wound care allows timely initiation of symptom-directed interventions to reduce pain, bleeding, odor, and infection risk. QoL improvements are often seen after the first follow-up visit, with the greatest benefit between the first and second visits. Access to structured wound care not only alleviates symptom burden but also supports continuation of oncologic treatment. Innovation: This study is the first to longitudinally assess malignant wound-related quality using a dermatology-specific instrument, the Skindex-16, in a real-world clinical setting. These findings highlight a model for integrating dermatologic wound care into supportive oncology and demonstrate that malignant wounds, often regarded as irreversible, can be meaningfully palliated with dedicated care. Conclusion: Dedicated wound care was associated with statistically significant improvements in QoL for patients with malignant wounds. Early referral to specialized wound clinics may enhance palliative care for these patients.
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