Management of non-healing wounds with honey dressings: a literature review

Caring for Patients With Malignant Fungating Wounds: A Scoping Literature Review

PURPOSE

The aim of this scoping literature review was to identify current knowledge related to management of malignant fungating wounds (MFWs), gaps in this knowledge, and areas for future research.

METHODS

This was a scoping literature review.

SEARCH STRATEGY

Six electronic databases (Embase, MEDLINE, Cochrane (CENTRAL), CINAHL, Scopus, and Web of Science) were searched spanning the years 1987 and 2022. The initial electronic database search retrieved 6041 studies. The search is based on 60 articles published between 1987 and 2022, along with 14 additional studies were based on search of reference lists of key articles.

FINDINGS

Studies were divided into 2 main domains; the vast majority (65 of 72, 87.8%) focused on symptom impact, measurement, and management. The remaining articles (n = 9, 12.2%) focused on caring for patients with MFW; these studies focused on nursing care experiences and competencies, along with lay caregiver experiences. Findings indicated that instruments have been developed to evaluate symptoms of MFW but only a few have been validated. Most of the studies reviewed evaluated the influence of MFW on physical and psychosocial function. Local and systematic symptom managements such as modern dressings, wound care strategies, surgery, and radiotherapy as well as chemotherapy were found to be effective in alleviating symptoms. Findings also indicated that families and nurses encounter obstacles and burdens when caring for patients with MFW; limited studies were retrieved that investigated the competence and needs of nurses in their caring journey.

IMPLICATIONS

Future studies should focus on: (1) using better designs to evaluate and compare topical agents and dressings to control odor, (2) validating assessment tools specific to MFW, (3) qualitative studies designed to enhance understanding family and nurses' experiences, and (4) improving the nurse's ability to care for patients with MFWs and their responses to managing these challenging patients.

Manuka honey and bioactive glass impart methylcellulose foams with antibacterial effects for wound-healing applications

Wound dressings able to deliver topically bioactive molecules represent a new generation of wound-regeneration therapies. In this article, foams based on methylcellulose cross-linked with Manuka honey were used as a platform to deliver borate bioactive glass particles doped additionally with copper. Borate bioactive glasses are of great interest in wound-healing applications due to a combination of favorable features, such as angiogenic and antibacterial properties. The multifunctional composite providing the dual effect of the bioactive glass and Manuka honey was produced by freeze-drying, and the resulting foams exhibit suitable morphology characterized by high porosity. Moreover, the performed tests showed improved wettability and mechanical performance with the addition of bioactive glass particles. Dissolution studies using simulated body fluid and cell biology tests using relevant skin cells further proved the excellent bioactivity and positive effects of the foams on cell proliferation and migration. Most interestingly, by the dual release of Manuka honey and ions from the copper-doped bioactive glass, an antibacterial effect against E. coli and S. aureus was achieved. Therefore, the multifunctional foams showed promising outcomes as potential wound dressings for the treatment of infected wounds.