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Review
. 2010 Aug;7(4):214-35.
doi: 10.1111/j.1742-481X.2010.00682.x. Epub 2010 May 28.

Care of chronic wounds in palliative care and end-of-life patients

Christine A Chrisman  1
Affiliations
Review

Care of chronic wounds in palliative care and end-of-life patients

Christine A Chrisman. Int Wound J. 2010 Aug.

Abstract

The aim of this paper was to provide a literature synthesis on current wound care practices for the management of chronic wounds in palliative care and end-of-life patients, focusing on the control of wound-related symptoms for comfort and improved quality of life. These wounds included pressure ulcers, venous and arterial leg ulcers, diabetic ulcers and fungating malignant wounds. Wound-related symptoms included pain, exudate, malodour, infection, bleeding, dressing comfort and negative psychological and social functioning. Best care wound practices were formulated for each wound type to ease suffering based on the literature review. Although symptom management strategies for comfort may work in tandem with healing interventions, it is important to recognise when efforts towards wound closure may become unrealistic or burdensome for the patient at end of life. Thus, unique aspects of palliative wound care feature clinical indicators for early recognition of delayed healing, quality of life measurement tools related to chronic wounds, and comfort care strategies that align with patient wishes and realistic expectations for wound improvement.

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Figures

Figure 1
Figure 1
Rating system for level and quality of evidence.
Figure 2
Figure 2
Complexity of wound healing. Reproduced with permission from Ref. .
Figure 3
Figure 3
National pressure ulcer advisor panel pressure ulcer scale for healing (PUSH). Reproduced with permission from Ref. .
See this image and copyright information in PMC

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