Topical opioids and antimicrobials for the management of pain, infection, and infection-related odors in malignant wounds: A systematic review

Kathleen Finlayson, Laisa Teleni, Alexandra L. McCarthy

Research output: Contribution to journalArticleResearchpeer-review

1 Citation (Scopus)

Abstract

Problem Identification: Patients with malignant wounds report pain, distress from odor and exudate, decreased self-esteem, and poor quality of life. This systematic review explores topical opioids, antimicrobials, and odor-reducing agents for preventing or managing malignant wound pain, infection, and odor. Literature Search: MEDLINE®, EMBASE, the Cochrane Library, CINAHL®, and reference lists were searched to identify relevant studies. Data Evaluation: Eligible study designs included interventions with pre-and postintervention data. Data extraction and risk-of-bias assessments were conducted using the Cochrane approach. Synthesis: No studies evaluated opioid use. Five studies (four randomized, controlled trials) evaluated topical antimicrobials for infection and odor. All studies reported clinically (but generally not statistically) significant improvements in outcomes. Conclusions: Although not as prevalent as before, 5%-10% of tumors, particularly in breast cancer, sarcoma, and melanoma, are expected to fungate. Gaps in the literature exist for use of topical opioids and antimicrobials for managing pain, odor, and infection control in malignant wounds. Implications for Research: Current recommendations for topical control of malignant wounds are based on case reports and observational studies in patients with breast cancer. Robust, controlled trials of topical opioid and antimicrobial use are warranted in patients with melanoma, breast, or head and neck cancer.

Original languageEnglish
Pages (from-to)626-632
Number of pages7
JournalOncology Nursing Forum
Volume44
Issue number5
DOIs
Publication statusPublished - 1 Sep 2017

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Pain Management
Opioid Analgesics
Wounds and Injuries
Infection
Pain
Melanoma
Breast Neoplasms
Reducing Agents
Exudates and Transudates
Wound Infection
Head and Neck Neoplasms
Infection Control
Self Concept
MEDLINE
Sarcoma
Libraries
Observational Studies
Breast
Randomized Controlled Trials
Quality of Life

Cite this

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title = "Topical opioids and antimicrobials for the management of pain, infection, and infection-related odors in malignant wounds: A systematic review",
abstract = "Problem Identification: Patients with malignant wounds report pain, distress from odor and exudate, decreased self-esteem, and poor quality of life. This systematic review explores topical opioids, antimicrobials, and odor-reducing agents for preventing or managing malignant wound pain, infection, and odor. Literature Search: MEDLINE{\circledR}, EMBASE, the Cochrane Library, CINAHL{\circledR}, and reference lists were searched to identify relevant studies. Data Evaluation: Eligible study designs included interventions with pre-and postintervention data. Data extraction and risk-of-bias assessments were conducted using the Cochrane approach. Synthesis: No studies evaluated opioid use. Five studies (four randomized, controlled trials) evaluated topical antimicrobials for infection and odor. All studies reported clinically (but generally not statistically) significant improvements in outcomes. Conclusions: Although not as prevalent as before, 5{\%}-10{\%} of tumors, particularly in breast cancer, sarcoma, and melanoma, are expected to fungate. Gaps in the literature exist for use of topical opioids and antimicrobials for managing pain, odor, and infection control in malignant wounds. Implications for Research: Current recommendations for topical control of malignant wounds are based on case reports and observational studies in patients with breast cancer. Robust, controlled trials of topical opioid and antimicrobial use are warranted in patients with melanoma, breast, or head and neck cancer.",
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Topical opioids and antimicrobials for the management of pain, infection, and infection-related odors in malignant wounds : A systematic review. / Finlayson, Kathleen; Teleni, Laisa; McCarthy, Alexandra L.

In: Oncology Nursing Forum, Vol. 44, No. 5, 01.09.2017, p. 626-632.

Research output: Contribution to journalArticleResearchpeer-review

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