Paper 5 Citation: Alvarez OM, Kalinski C, Nusbaum J, Hernandez L, Pappous E, Kyriannis C, Parker R, Chrzanowski G, Comfort CP.

Incorporating wound healing strategies to improve palliation (symptom management) in patients with chronic wounds

J Pall Med. 2007:10:1161-1189.

Abstract:
Palliative care patients may have a higher prevalence of wounds than non-palliative care patients. This article suggests approaches to wound care that includes palliative care considerations for symptom management. Evidence was presented for each type of wound care activity and palliation of symptoms was an integrated management strategy to complement curative wound care activities. The authors present the path through the mnemonic “SPECIAL”, which translates to Stabilizing the wound, Preventing new wounds, Elimination of odor, Control of pain, Infection prevention, Advanced, absorbent dressings, Lessen dressing changes. The authors present specific information for risk assessment in pressure ulcers, venous ulcers, ischemic ulcers, and malignant wounds. Care plans for each type of wound and specific activities, such as local wound care, cleansing, dressings, pain control, odor control, and emerging products and trends are covered with attention to palliative care strategies. The authors conclude that appropriate wound care plans consider symptom management and patient comfort in addition to other supportive and curative activities to improve both medical and quality of life outcomes.

Key words:
Palliative care, symptom management, chronic wounds, pressure ulcers, venous ulcers