Universität zu Köln

Uebach, Barbara, Krull, Elisabeth, Simon, Steffen T., Bausewein, Claudia, Voltz, Raymond and Doll, Axel (2022). Guideline-based Care for patients with malignant lesions The new S3 guideline for patients with incurable cancer. HNO, 70 (3). S. 167 - 179. NEW YORK: SPRINGER. ISSN 1433-0458

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Abstract

The German Association of Palliative Care developed an evidence-based guideline about the management of malignant wounds in adult patients with incurable cancer. There is a lack of evidence-based guidelines about fungating wounds and a confusing wide range of available wound dressings. The goal of the guideline is to reduce the suffering of patients with malignant wounds and stabilize or improve their quality of life. The guideline is constructed following the German Instrument for Methodological Guideline Appraisal (DELBI): A systematic review was carried out for guidelines and reviews. A wound expert group discussed these research findings and suggested recommendations which were adapted and consented by representatives of 62 medical and health professionals associations. The guideline has 34 recommendations, thereof nine (26%) are evidence based with an evidence level from 2+ to 4 (according to SIGN). The assessment chapter comprises specific assessment tools for malignant wounds, odor and wound-related quality of life. Three recommendations address the psychosocial support of patients and their family caregivers and aim to reduce the impact of the wound on their emotional wellbeing, caregiver burden and social participation. The pain recommendations focus on a preventive atraumatic dressing change, positioning, systemic pain medication (anticipated, rescue and baseline) and local application of morphine or local anesthetics. The guideline gives recommendations on odor management (metronidazole, active coal and antiseptic dressings) and management of exudate (super absorber). The recommendations on prevention and management of bleeding (antifibrinolytica, haemostyptica) are vital for patients and caregivers. This guideline is one of the first evidence-based and consented guideline on malignant wound care and has the potential to improve the palliation of patients who suffer from there malignant wounds.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Uebach, Barbara UNSPECIFIED UNSPECIFIED UNSPECIFIED Krull, Elisabeth UNSPECIFIED UNSPECIFIED UNSPECIFIED Simon, Steffen T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bausewein, Claudia UNSPECIFIED UNSPECIFIED UNSPECIFIED Voltz, Raymond UNSPECIFIED UNSPECIFIED UNSPECIFIED Doll, Axel UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-676986
DOI:	10.1007/s00106-022-01145-1
Journal or Publication Title:	HNO
Volume:	70
Number:	3
Page Range:	S. 167 - 179
Date:	2022
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1433-0458
Language:	German
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language QUALITY-OF-LIFE; FUNGATING WOUNDS; PALLIATIVE CARE; TOPICAL OPIOIDS; MANAGEMENT; ODOR; SYMPTOMS Multiple languages Otorhinolaryngology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/67698