Topical therapy for pain management in malignant fungating wounds: A scoping review.

Autor: da Costa Ferreira SA; Health Consulting and Education HFSaude, Sao Paulo, Brazil., Serna González CV; School of Nursing-EEUSP, University of São Paulo - Adult Health Nursing Graduate Program-PROESA, Sao Paulo, Brazil., Thum M; School of Nursing-EEUSP, University of São Paulo - Adult Health Nursing Graduate Program-PROESA, Sao Paulo, Brazil., da Costa Faresin AA; São Paulo State Cancer Institute-ICESP, Hospital das Clínicas, Faculty of Medicine, University of Sao Paulo-HCFMUSP, Sao Paulo, Brazil., Woo K; Faculty of Health Sciences, School of Nursing, Queen's University, Kingston, Ontario, Canada., de Gouveia Santos VLC; Medical-Surgical Nursing Department Research Group of Enterostomal Therapy Nursing Stomatherapy-GPET, Sao Paulo, University of São Paulo, School of Nursing-EEUSP, Sao Paulo, Brazil.
Jazyk: angličtina
Zdroj: Journal of clinical nursing [J Clin Nurs] 2023 Jul; Vol. 32 (13-14), pp. 3015-3029. Date of Electronic Publication: 2022 Sep 02.
DOI: 10.1111/jocn.16508
Abstrakt: Aims and Objectives: To map and synthesise the existing literature on topical therapies for malignant fungating wounds pain management and the gaps involved.
Background: Most cancer patients with malignant fungating wounds suffer from wound-related pain, affecting their quality of life. Unfortunately, even though pain is a relevant symptom in cancer and palliative care, little is currently known about topical treatments' availability and impact on pain management.
Design: A scoping review following JBI® methodology METHODS: Searches were performed in CINAHL, LILACS, Embase, Web of Science, PubMed, Cochrane, NICE, Scopus, JBISRIR and grey literature, in English, Portuguese and Spanish, with no time limit. Two authors independently reviewed all citations and a third was called in case of divergence, and studies in adults with malignant fungal wounds reporting topical pain interventions were included. In addition, a data extraction tool for synthesis and thematic analysis was developed. This study followed the PRISMA-ScR Checklist.
Results: Seventy publications were selected from 796 records retrieved from databases. The studies mainly included non-systematic reviews and case studies with only six clinical trials. According to the narrative synthesis, twenty therapies were identified, including the use of wound dressings (58.6%), analgesic drugs (55.7%), topical antimicrobials (25.7%), skin barriers (15.7%), cryotherapy (5.7%) and negative pressure wound therapy (4.3%). Therapies were recommended to be applied to the wound bed or the periwound skin. In 68.5% of the studies, a standardised assessment for pain was not described.
Conclusions: Topical therapies applied to malignant fungating wounds or periwound areas had been examined for pain management. However, their effectiveness was analysed in a few interventional studies, indicating the need for further primary studies to inform evidence-based practice.
Implication for Practice: Highlighted topical therapies for clinical practice consideration are opioids, anaesthetics and antimicrobials, with positive results described in randomised clinical trials. This study did not include patients.
(© 2022 John Wiley & Sons Ltd.)
Databáze: MEDLINE
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