Malignant Wound Management and Pain Relief

This document provides a comprehensive overview of malignant wound management, including wound assessment, risk factors, and treatment options. It also covers pain relief strategies and health education for patients. The assignment discusses the importance of maintaining cleanliness, using suitable dressings, and changing dressings regularly to promote wound healing and prevent infection.

Case Study

INTRODUCTION
Wound management refers to an ongoing process of wound treatment with the help of
providing appropriate environment of healing by direct and indirect methods along with
prevention of skin breakdown. It can be considered as complex procedure in which skin and
tissues repair themselves after an injury (Pavletic, 2018). The present report is based on given
case studies related to Mr. Will Jackson and Mrs. Miriam Gold including their health wounds
and health condition. It will focus on wound management plan by conducting holistic
assessments of patients and evaluation of type of wounds present in both cases. The wound
management plan, health education about wounds and pain management is give below.
CASE STUDY 1
Holistic assessment of patient
According to given case, Mr. Will Jackson is a 77 years old man who has been admitted
to the ward for pain management, SOB and wound management. However, the medical history
of this patient includes IHD previously CABG (2 years ago), COPD, ETOH, GORD, postural
hypotension and T2DM on insulin. The assessment has been done with the help of carrying out
CT Scan which results into NAD along with analysing a massive bruise on face due to fall at
home with head strike. Regarding types, it is examined that he has a diabetic foot ulcer, arterial
ulcer seems to be infected and has 2 small pressure ulcers on his sacrum bone.
The diabetic ulcer refers to a common complication of poorly controlled diabetes which
results into breakdown of skin tissue and exposing layers underneath. Arterial ulcers created as a
result of damage to the arteries due to lack of blood flow of tissue. Pressure ulcer refers to wound
that develops when constant pressure or friction on sacrum of body damages skin (Bano And et.
al., 2017). The investigation of wounds is required to determine kind of infection in order to
advice accurate medication for the same. Principles of wound management consist haemostasis,
cleaning the wound, analgesia, skin closure and dressing & follow up advice.
Evaluation of each type of wound
The diabetic ulcer is yellowish in colour and surrounding skin appears to be red whereas
arterial ulcer is seems to be infected with pus appearing red on surrounding skin. It is advised to
wound swab to be taken and send to pathology and analyse that it is infected. The sacral ulcer
cause severe pain when patient tries to lying in supine position.
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Expectation of healing process and influencing factors
The wound healing process has been expected to be effective in order to make patient
feel easy and overcome with the problem. There are several factors which are responsible for
influence healing procedure of wounds such as diabetes, old age, poor oral intake, intermittent
confusion situations and IHD previously CABG (2 years ago), COPD, ETOH, GORD.
Wound management plan
Wound management plan is based on selected principles such as haemostasis, cleaning
the wound, analgesia, skin closure and dressing & follow up advice. In context of given case, it
is necessary to stop bleeding of diabetic & arterial ulcer and reduce pressure regarding sacral
ulcer (Vowden and Vowden, 2017). Cleaning of all three wounds is required and use antibiotics
for avoiding any kind of infection in wounds. However, analgesia should be used for closure of
arterial, sacral and diabetic wounds. Moreover, the tissue adhesive glue and skin adhesive strips
can be used for closure of these wounds in case of Mr. Will Jackson. Additionally, the dressing
of wounds is required for place first layer of absorbent material and then after soft gauze tape to
secure dressing area.
Health education for patient regarding wound
In case of Mr. Will Jackson, he has been suffered from burn then it is necessary to
provide education about the same to him. It is necessary to wash hands and keep the bandage dry
between changes. However, clean wound with soapy cloth and then dry it gently with clean
towel to apply antibiotic ointment and place dry & clean bandage.
Pain management of wound
The pain management of selected patients consist number of steps which are required to
be carried out in proper manner. However, it is necessary to prevent infection by providing
suitable medications because severe infections are responsible for crucial pain in wounds.
Moreover, change dressing of wound regularly which make an individual feel relived from pain
and provide anti-inflammatories, antibiotics, or other medications to relieve the pain (Lattimore
and Mosholder, 2014).
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CASE STUDY 2
Holistic Assessment of patient
The medical history of Mrs. Miriam Gold is COPD, GORD, CABGs and drowsy &
vague which has been analysed by examining malignant groin area and observed peri anal area is
burning red due to bowel incontinence & discharge from her cervical cancer. Moreover, it is
determined that she has a long standing venous ulcer that is not healing. The wound principles
consists haemostasis, cleaning of wound, analgesia, skin closure and dressing & follow up
advice.
Evaluation of each type of wound
The malignant wound is observed in groin area caused due to bowel incontinence &
discharge from her cervical cancer. Her wound has very strong odour appearing reddish brown in
colour having severe pain. However, the surrounding skin seems to be red and infected and
appeared to be painful.
Expectation of healing process and influencing factors
The expectation of healing process is to maintain wound try and infection free in order to
reduce pain and make patient overcome with the same. In this case, number of factors impacts on
healing procedure including medications related to Pneumonia & metastatic cervical cancer and
past problems like COPD, GORD, CABGs, drowsy as well as vague.
Wound management plan
Considering case of Mrs. Miriam Gold, it is required to establish an effective wound
management plan to make her feel comfortable. Initially, the wound is required to be dry by
using suitable medication and dressing. However, risk assessment to determine problem of
creating severe infection in wound which may results into critical condition. It is essential to stop
bleeding first and assess wound by wearing gloves. Moreover, irrigate wound with saline and
provide antibiotics to patient to improve progress to overcome with malignant wound.
Meanwhile, use analgesia to carrying out closure of wound easily and utilise adhesive stripe &
glue to avoid infection dressing. Furthermore, by placing absorbent material the soft gauze tape
should be placed for securing the dressing.
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Health education for patient regarding wound
The malignant wounds are considered as chronic which takes around 6 weeks to be
properly overcome. It is necessary to educate Mrs. Miriam Gold to maintain cleanliness of groin
area and put that place dry to avoid growth of infectious bacteria. It is necessary to change the
dressing in regular basis very carefully for gain relief and overcome soon. However, taking all
precautions but still feeling uneasy then immediately consults with physician to avoid
complications. Moreover, take medications on time and eat food as per advice of doctor.
Pain management of wound
Pain management include taking medications on time which has been prescribed by physician. It
is necessary to determine the cause to treat the pain in proper manner. If exposure to air create
extreme pain then it is required to cover the wound properly which helps to reduce the painful
condition. However, use suitable dressing for wound which did not develop pain at wound site
because it is favourable to overcome with same very soon. Pain should be assessed on regular
basis and use suitable technique to remove it. Moreover, suitable medications are also supportive
to feel relived from the pain, in case of malignant wound, the pain is very critical then doctors
can use distraction therapy to make patient feel comfortable.
Conclusion
From the above report, it has been analysed that wound are of different types which has
their own process of healing in order to make people feel relieved. It include several factors like
present condition, past health problems and current intake of certain medications which impacts
on treating process because most suitable medications is required. Wound management can be
done through applying accurate methods and conducting pain management properly.
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REFERENCES
Books and journals
Pavletic, M. M. (Ed.). (2018). Atlas of small animal wound management and reconstructive
surgery. John Wiley & Sons.
Bano, I. And et. al., (2017). Chitosan: A potential biopolymer for wound
management. International journal of biological macromolecules. 102. 380-383.
Vowden, K., & Vowden, P. (2017). Wound dressings: principles and practice. Surgery
(Oxford). 35(9). 489-494.
Lattimore, J. D., & Mosholder, M. B. (2014). U.S. Patent No. 8,791,315. Washington, DC: U.S.
Patent and Trademark Office.
Lall, R. R. and et. al., (2015). Evidence-based management of deep wound infection after spinal
instrumentation. Journal of Clinical Neuroscience. 22(2). 238-242.
Quain, A. M., & Khardori, N. M. (2015). Nutrition in Wound Care Management: A
Comprehensive Overview. Wounds: a compendium of clinical research and
practice. 27(12). 327-335.
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