Palliative Management of Malignant Fungating Wounds

Malignant fungating wounds arise when cancerous cells infiltrate the skin, producing ulcerative or nodular lesions that are prone to pain, malodour, bleeding, necrosis and copious exudate. These wounds affect a significant minority of patients with advanced malignancies, often signalling a limited prognosis and complex care needs. Palliative management prioritises symptom control, psychosocial support and maintenance of dignity rather than curative intent. Common interventions include tailored dressings—such as alginate or charcoal-infused materials—to absorb exudate and mitigate odour, topical antimicrobial agents to reduce bacterial burden, haemostatic measures to control bleeding and analgesic regimens to address pain. Multidisciplinary collaboration among oncologists, surgeons, wound care specialists, nurses and palliative care teams is central to individualising care plans. Emerging approaches explore the role of the wound microbiome in symptom severity and investigate novel topical formulations to target odour-producing bacteria. Holistic assessment encompasses physical, emotional and social dimensions, recognising the profound impact of visible malignant lesions on body image, self-esteem and caregiver burden. Globally, resource-sensitive protocols and education of healthcare professionals remain critical to improving quality of life for patients living with these challenging wounds.

Research from Nature Portfolio

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Palliative Management of Malignant Fungating Wounds publication trend

The graph below shows the total number of articles in palliative management of malignant fungating wounds across all publications each year (not limited to Nature Index journals).

Technical terms

Malignant fungating wound: A cancer-driven skin lesion characterised by ulceration, necrosis and often friable tissue.

Palliative care: An approach focused on relieving symptoms, improving quality of life and supporting patients and families facing serious illness.

Exudate: Fluid, often protein-rich, that leaks from blood vessels into a wound and can promote bacterial growth if uncontrolled.

Malodour: Unpleasant smell from a wound, typically resulting from bacterial metabolism of tissue breakdown products.

Necrosis: Death of cells or tissues in and around a wound, contributing to inflammation, odour and infection risk.

References

1. The Microbiome, Malignant Fungating Wounds, and Palliative Care. Frontiers in Cellular and Infection Microbiology (2019).
2. Management of malignant cutaneous wounds in oncologic patients. Supportive Care in Cancer (2022).
3. Treatment Algorithm for Cancerous Wounds: A Systematic Review. Cancers (2022).
4. Resigning oneself to a life of wound-related odour – A thematic analysis of patient experiences. Journal of Tissue Viability (2023).
5. Defining palliative wound care: A scoping review by European Association for Palliative Care wound care taskforce. Journal of Tissue Viability (2023).