Tumor Wounds
What are Tumor wounds ?
The term “Tumor wounds” refers to any wounds, that occur in the course of tumor growth and/or tumor treatment
What Forms of Tumor wounds are there?
Exulcerating Tumor wounds
Tissue defects after tumor resection
Complication management of defects caused by tumor treatment
Chronic lymphedema after Tumor surgery and/or radiotherapy
Extravasation injury after Chemotherapy
Actinic injury after Radiotherapy
Ulcerating cancers are sometimes called fungating cancers (tumors) or wounds. These wounds start when a tumor growing under the skin breaks through the skin’s surface.
Exulcerating tumor wounds may lead to severe impairment of the patient caused by
- Bleeding
- Pain
- Secretion
- Bad Smell (odor)
- Impairment of surrounding normal skin due to dressing
 | In the case of a chronic non-healing skin wound, tumor growth must always be considered. |
Depending on the type of tumor different techniques of tumor resection can be applied:
- Intralesional excision (incisional biopsy): Removal of tumpor tissue for pathological examination
- Marginal excision (excisional biopsy): Removal of total tumor for histological examination
- Wide resection: resection of tumor with additional safety margin
- Radical excision: resection with additional structures of a body compartment
Complication management of defects caused by tumor treatment
Early and adequate management of complication cause by the tumor treatment itself is mandatory for
- Possibilities of adjuvant treatments
- Quality of life
Lymphedema refers to tissue swelling caused by an accumulation of protein-rich fluid that’s usually drained through the body’s lymphatic system. Lymphedema can be a side effect in 15 % to 40 % of patient with breast cancer, due to
- breast cancer surgery
- radiation therapy
Radiodermatitis (radiation dermatitis, radiation-induced skin reactions, or radiation injury) is a significant side effect of ionizing radiation delivered to the skin during cancer treatment. There are acute and chronic effects
Short-Term side Effects (days)
- Redness of the skin on the irradiated breast
- Dryness (itching)
- Temporary swelling
Medium-Term side Effects(months)
- (Hyper)pigmentation
- Hardening of the breast and overlying skin
Long-Term side Effects (> 3 months – years)
- Actinic Ulcers(→ squamosam cell carcinoma)
What are the consequences of a Tumor wounds?
Exulcerating tumor wounds may lead to severe impairment of the patient caused by
- Bleeding
- Pain
- Secretion
- Bad Smell (odor)
- Impairment of surrounding normal skin due to dressing
Adequat defect reconstruction after tumor resection determines:
- Possibilities of postoperative adjuvant treatment
- Quality of life
How can you treat a Tumor wound ?
Whenever possible a complete tumor (R0) resection must be carried out. A histological control of the margins and the bottom of the resected tumor (wound) is always necessary. The resulting defect must be covered as soon as possible.
If tumor wound resection is not possible for any reason, the following requirements for the wound dressing must be taken into consideration:
- Mechanical protection of the wound
- No adhesion of the dressing with the wound (fat gauze, ….)
- Minimal discomfort/pain cause by dressing
- Adequate wound secretion management
- Adequate wound smell management
- Minimal irritation of the surrounding skin
