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Dealing with fungating wounds?

12 Feb 2018 09:44

Hi,

Posted this originally on 'Living with cancer' and was advised to try on this.

I have been seeing the nurse at my GP surgery for a few weeks to have my fungating wounds on my breast dressed. It started with honey patches, then moved to honey on gauze, then a honey wound care ointment all these helped mask the smell and to start with it was great, I was quite happy with this, well as happy as could be in the situation. My GP also gave me antibiotics as there was quite a lot of pus, this seemed to help the smell initially. But as soon as the anti biotics have stopped the smell has got worse. I really dont fancy using antibiotics nor would I think it sensible given that I dont want to build up a resistance to them as I may need them for something else during treatment (hopefully not)

Now the hospital have told me to swap to a carbon type dressing to help with the odour as I was getting more wounds which were starting to leak and smell. The also think they the wound has gone beyond honey and I need something with silver in. I find these make the smell seem worse as I'm not allowed to use adhesive dressings over the top of it because my breast is swollen, the skin is pelling off. They seem to think the adhesive dressings is making it worse. I have been given the kerramax pads which just sit in my bra I have to use 2 at a time which I seem to leak through within an hour, through the bra and top. So when I go out I have to make sure I keep my coat on as im not sure what state my top will be in if I take it off. The smell is there contantly now, even in the shower it never goes away.

The wounds are getting worse because in the past 3 weeks I have developed 2 more, a smaller one and a much larger one. They start as ulcers which are painful then when they burst that is when the leakage and smell start.

I know my oncologist said the chemo should help a bit which I start tomorrow morning but what do I do in the mean time as its getting much worse? It's going to take a while to get on top of.

I know it sounds daft but this is my biggest problem at the minute, we all want to live life as normally as possible, but with this I find it quite difficult to spend time with friends ect for fear of the strong smell and leaking through my top. 

Any advice on how did you manage the leakage/smell problem as I know I cant be the only one who has faced this? Is there anything I can do to help?

Re: Dealing with fungating wounds?

13 Feb 2018 15:43 in response to Reflexstar

Hello Reflexstar,

Thank you for posting a question. I am sorry to learn about your situation. I can certainly understand that this is having a negative impact on your quality of life.

I must admit that I am at a bit of a loss about what to recommend, but I will try to make a few suggestions.

In terms of the KerraMax pads, I am wondering if the problem is that they are not absorbent enough, or if the leakage occurs because they cannot be stuck down.  If it is because they cannot be stuck to your skin, you could ask the nurse at the surgery if they think an elastic stretch net dressing might help keep them in place. The net uses gentle pressure to keep bandages or other medical dressings in place without adhesive tape. I don’t know for sure if this would work, but it may be worth a try.

If the dressing pads are not absorbent enough, you can use one on top of the other but this will add more weight. There are also other super absorbent dressing on the market and your nurse may be able to suggest another type. When wounds have an unpleasant odor and they are also very wet activated charcoal dressings are often used over the top of the absorbent dressing. So this is why your nurse has suggested this.

I can understand your reluctance to have antibiotics, but keeping the infection down will help control the odor from the wound. It might be enough to apply an antibiotic directly to the wounds. This is called a topical antibiotic and this should not cause you to become resistant to other antibiotics should you need them in the future. I understand that you don’t think that the silver helped. This has antibacterial properties and so it can be helpful for some people with infected wounds. Silver can be in the dressing or applied directly to the wound. Iodine preparations can also be antibacterial and there are a number on the market that can be used.  You could ask about this, but there may be a reason that I don’t know about which makes this unsuitable for you.

As you pointed out, chemotherapy could help as treating the cause can help the wounds to heal. But of course this does not help you right now. I wonder if it is worthwhile asking your GP’s surgery if they think that you might benefit from seeing a wound care specialist. This is usually a nurse. While GP practice nurses  and community nurses are usually very good at wound care, as it is a large part of their job, specialist wound care nurse will have additional experience and expertise. So they may be able to help further.

I do hope that things improve for you soon. If you have any other questions do get back to us. If you  would like to telephone our freephone number is 0808 800 4040.  We are here from Monday to Friday between the hours of 9am to 5pm.

All the best,

Jean

 

Re: Dealing with fungating wounds?

14 Feb 2018 18:36 in response to CRUK Nurse Jean

Thanks Jean,

I'm off to the doctors tomorrow so will ask about the above and see where we go from there. 

Thanks again for your suggestions.

Pauline x