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What Is a Fungating Wound?

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  • Written By: Mary McMahon
  • Edited By: Kristen Osborne
  • Last Modified Date: 20 November 2014
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A fungating wound is an injury caused by the growth of a cancerous tumor through the skin. This type of cancer complication is rare and occurs most commonly in cases where people are receiving palliative care only for cancer, as usually surgery, chemotherapy, and radiation suppress cancer growth enough to prevent the development of fungating wounds. These injuries can superficially resemble a cauliflower or fungus protruding from the skin, and they can cause significant hardships for patients, in addition to presenting a nursing challenge.

Fungating wounds develop as a cancer spreads under the skin and eventually pushes through the layers of skin to the surface. Along the way, it causes necrosis or tissue death, usually leading to inflammation and infection. The open wound tends to attract bacteria, leading to secondary infection. Usually, there is a strong smelling discharge and the wound will feel hot and moist to the touch.

Management of a fungating wound includes administering medication to inhibit bacterial growth, debriding dead tissue, and regularly cleaning and bandaging it. Drains may be placed to allow pus and other fluids to freely drain from the injury. Bandages can help control odor, although it is important to change them regularly to avoid exacerbating inflammation or promoting the development of further infection. The fungating wound can increase in size as the cancer grows, causing a very large lesion to appear.

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Patients often experience emotional distress when a fungating wound develops. The injury is a reminder of the terminal nature of the cancer and patients may express regret about not pursuing more aggressive treatments. In addition, the pain and smell can cause emotional distress as patients feel increasingly uncomfortable and may be worried about how other people will respond to the wound. Skilled nursing care paired with appropriate mental health interventions can help cancer patients in the end stages of their lives.

When a fungating wound develops, patients should talk to their doctors about options for managing and treating the injury. Every patient's case is slightly different, and a wound care specialist may be called in to provide assistance. It is also advisable to prepare friends and family members when they visit the patient so they know what to expect and are not startled by the patient's declining health. While the wound may not be visible, it can produce an odor and it is important for visitors to know that the wound is being cared for, not neglected or ignored.

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anon260392
Post 3

My mom has had a fungating wound for about seven months now. It has increased in odor.

I have been an acute care nurse for over 20 years and have never seen the likes of this. She has had radiation treatments, and now is offered a 20 percent chance of reduction (for how long?) with chemotherapy. I think she is trying every effort to beat this squamous cell carcinoma (which is her primary, located in her left chest wall - not lung, not breast - nothing to show a primary).

I am thankful for all the online sites to help inform me and my family regarding fungating wounds.

KaBoom
Post 2

@SZapper - I agree that specialized care is necessary for conditions like fungating wounds. I have a good friend who is a nurse. She told me that while all nurses get the same kind of general education, they learn a lot on the job too.

My friend works in the ER, so she deals with a lot of drug overdoses and accidental wounds. I asked her and she said she's never seen a fungating wound. However, I'm sure most hospice nurses are familiar with the condition.

SZapper
Post 1

It's conditions such as this one that make hospice nurses and hospice care in general so important. For those that aren't aware, hospice care is basically medical to care to make terminally ill patients comfortable once there is nothing more that can be done for them.

I've had a few experiences with elderly relatives and I'm a big believer in hospice care. Most hospices have compassionate nurses that are well versed in dealing with conditions such as fungating wounds. Skilled and compassionate treatment can make a huge difference in the quality of life in a dying patient.

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