Ms Zhao Yu Jacqueline Teo1, Dr Yaojie Shuy1
1Vickycares, Singapore, Singapore
ABSTRACT
Background
Malignant wounds cause significant physical and psychological sufferings to patients with advanced cancer. A holistic support and specialized wound care are vital in caring for patients with extensive malignant wounds at home.
Patient, Mdm Z, had advanced recurrent SCC Cervix which invaded her bladder and colon. At her final stage, patient was too lethargic to be transported to hospital for sedation during dressing change, hence the homecare team was activated.
Objectives
This case study demonstrates that with home team support and specialized wound care, patient with extensive malignant wound is able to manage at home, thus allowing patient to spend her final time at home.
Interventions
Mdm Z has three fistulas over abdomen with bones and organs exposed. Fecal material and urine also pooled in the cavity. Due to the location of the wounds, pouching using the usual stoma bag was impossible. This made the care of patient at home difficult as there was constant leakage which caused moisture-associated skin damage. To ensure comfort and optimal pain control during the dressing change, homecare doctor administered intravenous medication. With the help of home palliative nurse and specialized wound care nurse, wound was flushed with sodium chloride 0.9% and suction was done using suction machine. Edges were protected with hydrocolloid wafer and strip paste. Coloplast Wound Manager was used to contain the fecal material and urine.
Results
Mdm Z’s caregiver was able to manage the care in between the change. The moisture-associated skin damage had improved. Mdm Z managed to spend the final stage of life at home with her husband and 2 young children.
Conclusion
With holistic hometeam support and specialized wound care, patients with extensive malignant wound can be managed at home. This creates more peace, maintain emotional well-being, thus leading to greater satisfaction of end-of-life care.
Biography:
Jacqueline has been a wound and stoma speciality nurse since 2017. She had attained Graduate Diploma in Wound, Ostomy and Continence in 2016 and Master of Science (Clinical Nursing) in 2017 from Curtin University. Being oncology-trained, Jacqueline had managed patients with extensive malignant wound in homecare setting. She is also an active member in the WOCN Chapter, Singapore.