Palliative Wound Care for Malignant Fungating Wounds: Holistic Considerations at End-of-Life.

Timely, holistic interventions aimed at easing the despair of patients with advanced cancer and malignant fungating wounds (MFWs) must incorporate patient and family goals of care in all aspects of decision-making. People with MFWs suffer from a devastating and often crippling symptom burden including disfigurement, pain, pruritus, malodor, exudates, and bleeding. These symptoms may lead to psychosocial and/or spiritual distress, isolation, and diminished quality of life. The complexity of caring for hospice patients with MFWs requires a pragmatic and holistic interdisciplinary approach guided by specialist-level palliative wound care. This article introduces a framework to assist clinicians in the assessment and management of terminally ill patients with MFWs.