Symptom Management and Quality of Life in Oncology Patients With Inoperable Wounds: Comparison of Two Dressing Approaches.

Abstract

IntroductionMalignant or inoperable wounds are among the most challenging conditions in oncology and palliative care. These wounds are associated with complex symptoms such as infection, necrosis, heavy exudate, malodor, and pain, all of which negatively affect patients' physical, psychosocial, and functional well-being, and significantly reduce quality of life. Despite various wound care approaches in clinical practice, studies focusing on symptom burden and quality of life remain limited. This study aimed to evaluate symptom burden and quality of life in oncology patients with inoperable wounds.MethodsThis prospective comparative study was conducted with patients admitted to the Wound Care Clinic of Sakarya University Training and Research Hospital between December 2023 and June 2024. A total of 33 patients were allocated according to the treatment strategy applied in routine clinical practice. Two patients in the PHMB group died during follow-up, resulting in a final analytic sample of 31 patients (PARAF, n = 16; PHMB, n = 15). The control group received PHMB-containing dressings, while the experimental group was treated with boric acid powder and paraffin-impregnated tulle dressing (PARAF). Data were collected using the Patient Information Form, Wound Care Form, and Edmonton Symptom Assessment Scale. Inflammatory markers (C-reactive protein and erythrocyte sedimentation rate), symptom outcomes (odor, pain), and mortality were assessed at week 1, month 1, and month 3.ResultsNo significant difference was found between groups in terms of wound size. Although changes in inflammatory parameters were observed during follow-up, no statistically significant differences were found between groups regarding wound size, ESAS scores, or overall Wound-QoL-17 scores. An isolated statistically significant difference was observed in one Wound-QoL-17 item at the first-month assessment; however, this finding should be interpreted cautiously given the multiple comparisons. Overall, both dressing approaches demonstrated comparable outcomes in symptom management and quality of life during follow-up. No deaths occurred in the PARAF group, whereas two patients in the PHMB group died during follow-up.ConclusionAlthough no differences in wound size were observed between the two methods, slight improvements in symptoms and quality of life were noted. This suggests that palliative dressing approaches, even if they do not directly accelerate wound healing, can contribute to enhancing patients' daily functioning and overall comfort.