Q&A: Wound Care for Cancer Patients
CancerWise - November 2008
As if their bodies didn’t already have enough to deal with, cancer patients sometimes face issues with the healing of wounds, which may be caused by a variety of factors.
Answering questions about cancer and wound care is Julie Ortiz, a wound, ostomy and continence (WOC) registered nurse at M. D. Anderson. Ortiz has been a certified WOC nurse for six years.
What types of wounds do cancer patients have?
Cancer patients may have wounds caused by cancer, cancer treatment or another condition not related to cancer.
Conditions classified as wounds include:
- Skin reactions to radiation
- Surgical incisions that are open or slow to heal
- Pressure ulcers (bed sores)
- Pain caused by neuropathic ulcers
- Ulcers from poor circulation
What are some of the latest advancements?
Wound-care products include:
Hydrofiber: More absorbent than gauze, this material helps contain the drainage from the wound and keeps the wound moist.
Topical products containing silver: These products lessen the chance of infection. Fewer people develop sensitivity to them than to other topical antibiotics. Some products release silver over several days, decreasing the need for daily dressing changes.
Wound V.A.C.® or negative pressure wound therapy: The wound is filled with porous foam and sealed with clear plastic. A tube attached to a small vacuum pump keeps wound drainage from collecting in the wound and causing infection. Dressings can be changed two to three times a week rather than each day. The wound heals faster because the vacuum stretches the tissue and keeps drainage from pooling in the wound.
Can incontinence cause skin irritation?
Bowel or urinary incontinence from cancer treatment can cause skin irritation because the skin may be wet constantly or may react to the enzymes in urine or stool.
How can incontinent patients protect their skin?
- Keep the skin as dry as possible
- Wear disposable absorbent pads or briefs
- Treat skin with barrier creams such as:
- Petroleum jelly
- Instead of wiping with toilet paper use either:
- Moist perineal wipes
- Soapy water from a squeeze bottle
One product we use to treat patients is a spray that leaves behind a thin layer of plastic to keep the skin dry. Also, we use other skin barriers and waterproofing agents, including topical products like zinc oxide, silicone, lanolin and beeswax preparations.
How do wounds change dietary requirements?
Protein is a basic building block of good nutrition, and it’s especially important in healing. Medical literature suggests that a person with a wound, such as an open surgical incision, needs about twice the amount of protein as is normally required.
It’s almost impossible to get that amount without supplementing your diet. Patients also may need extra magnesium, zinc and vitamin C. Often a daily multivitamin is sufficient.
Healing also burns calories, so more calories may be needed. Patients should talk to a dietitian or their health care providers about their diet and the possibility of supplements.
What can patients do if they have a wound?
They should closely follow their health care provider’s instructions for wound care. If they notice any change in their skin at or around an incision or other wound, or if a wound “just doesn’t feel right,” patients should promptly bring it to the attention of their health care providers.
Chemotherapy can weaken patients’ immune systems, and a minor cut could turn into a major problem.
To care for cuts, patients can:
- Keep the wound clean with a deodorant soap and water
- Cover it with a bandage
- Notify their doctor if it hasn’t healed in a week
- Call someone immediately if the wound has:
- Increased pain
Dry skin can be protected with moisturizing lotion.
How can patients find a WOC nurse?
WOC nurses do not practice independently, so I advise patients to find a wound care center in their area or a home health agency with a WOC nurse or similar wound specialist.
WOC nurses can be found around the world, and there are more than 4,000 members of the Wound, Ostomy and Continence Society.
For educational materials or to find a WOC nurse, visit Wound, Ostomy and Continence Nurses Society.
M. D. Anderson resources:
- Wound, Ostomy and Continence Nursing