Fungating wounds

 DO

• Grade the wound according to the staging system of fungating wounds.

Staging of fungating wounds

Grade I Intact epidermis with imminent skin deterioration due to underlying tumour tissue. 

Grade II Incipient encroachment of the subcutis.

Grade III¹ Deep penetration with encroachment of the subcutis. 

Grade IV¹ Dry and/or confluent necrosis up to 30% of the wound surface. 

Grade V¹ Dry and/or confluent necrosis on more than 30% of the wound surface. 

¹For grades II through V, exudate, bleeding tendency, pain and itching may be present.

 




 DO

• Provide clear information to child and family about fungating wounds. Explain that priority is given to the child's comfort and pay attention to the psychosocial consequences of the cancerous ulcer. Provide psychosocial and/or spiritual support if necessary.
• If possible, treat the underlying malignancy.
• Clean the wound and care for it using wound dressings and locally or systemically administered medications.
• Treat factors that adversely affect the fungating wound, such as poor nutrition/hydration status, pressure spots, oedema formation.

 
 DO

• Evaluate the effect and side effects of the treatment instituted at the appropriate time, and adjust treatment as needed. Involve child and family in this process.