The project aims to provide a synthesis of the current evidence on management of core symptoms in palliative wounds. It will support health care professionals in their selection of the best strategies for management of palliative wounds and to enhance patient outcomes, research and education in this field.
The focus of research and education in wound care has primarily been on chronic wounds including venous, diabetic and pressure ulcers. Interventions in these wounds are aimed at healing outcomes. However, little attention has been given to wounds in patients that are unlikely to heal or that require a transient palliative care approach. For many of these patients with palliative wounds, including but not limited to malignant fungating wounds, managing the distressing symptoms of these wounds is a daily challenge and also a reminder of a failing body. Some of the inherent challenges for patients, carers and clinicians are lack of evidence on current options to manage such wounds and lack of education on how to manage them.
There is a need to review the evidence and identify, from the point of view of patients as well as health care professionals, the current clinical challenges and opportunities in palliative wound management.
The objectives of this initiative will be to:
- Systematically review the evidence for the management of wound-related symptoms in palliative care, including for example: exudate, bleeding, and peri-wound area. Of note, pain and odour are major problems but a current EWMA Document on pain is addressing this and another systematic review on wound odour has been accepted for publication, and therefore both are excluded from this objective.
- Identify, from health care professionals, via an online survey, the current challenges in the management of palliative care wounds. This will include wound symptom management, dressing selection, repositioning in the case of pressure ulcer prevention and management and skin protection.
- Identify, from patients, the unmet needs and challenges in their wound management.
- Develop a one-page guidance document with recommendations for clinical practice (available in English, French, German, Italian and Spanish) as well as short 1-3 minute videos explaining best practice in managing palliative wounds suited for social media and the EWMA website.
- Editor: Sebastian Probst (Switzerland), Immideate Past President of EWMA, Full Professor of Tissue Viability and Wound Care Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland
- Editor: Georgina Gethin (Ireland), Head of School of Nursing & Midwifery, University of Galway
- Jan Kottner (Germany), President of EPUAP, Director of Institute for Clinical Nursing Science, Charité – Universitätsmedizin Berlin
- Ana Lamza (Croatia), Vascular Surgeon, Clinical hospital "Sveti Duh" University of Zagreb
- Sylvie Meaume (France), Head of Geriatrics Wounds and Healing Department, Hôpital Rothschild, AP-HP. Sorbonne Université
- Elena Conde Montero (Spain), Dermatology consultant, Hospital Universitario Infanta Leonor Madrid
- Fiona Rawlinson (UK), Professor, Postgraduate Course Director Palliative Medicine/Care, Cardiff University School of Medicine
- Christina Megal (USA), Clinical Director, Integrated Wound Healing Program, Assistant Professor at Medical College of Wisconsin (Repr. The Wound Healing Society (WHS))
- Hayley Ryan (Australia), Board Director and Chair of Wounds Australia, Wound CNC, Adjunct Lecturer University of Technology Sydney (Repr. Wounds Australia)
- Project initiation: August 2023
- Expected publication: Early spring 2025
- Launch: EWMA 2025 Conference, Spain
This project is supported by an unrestricted educational grant from: