In my literature review, I have so far found only one case study of an ulcerating malignant wounds / lesions being successfully healed using proper wound bed preparation and the TIME paradigm. Hardly any available literature indicates these types of wounds can be healed; they are usually managed with conventional methods of topical agents, debriding, dressings, and pain management if radiation treatment, chemotherapy or surgery are not deemed suitable or have been ineffective.
If it's a fungating, malignant wound, you can't heal it. Moist wound healing won't make a tumor go away. Surgery may be possible to remove it, perhaps with radiation or chemo as an adjunct. A graft or flap may be necessary at the end to close the deficit. The ones I've seen have usually been palliative cases, where we're working on comfort, odor, pain, and exudate management. I'd be interested in that case study you reference. Can you share the citation?
Thanks Renee,
This is a link to the case study I was referring to: http://www.magonlinelibrary.com/doi/abs/10.12968/jowc.2007.16.9.27867?journalCode=jowc.
I am aware of the fact, that healing such wound does not eliminate underlying cancer; it requires additional treatment with surgery as one potential treatment path if chemo or radiation are not options anymore such in this case study.
Malignant degeneration in scar tissue is historically known by the eponym ‘‘Marjolin’s ulcers.’’ Most Marjolin’s ulcers occur in burn scars, with the incidence of burn-scar neoplastic degeneration reported at between 0.77 and 2.0%. Marjolin’s ulcers have also been escribed in other types of scarring and chronic inflammation. 1, 2
Dr. Jean Nicolas Marjolin first described the occurrence of ulcerating lesions within scar tissue in 1828. Marjolin’s ulcer is the term given to these aggressive epidermoid tumors that arise from areas of chronic injury, with burn wounds being a common site. 3
The exact mechanism of malignant transformation of Marjolin’s ulcer remains unclear and controversial. Several theories including the toxin, chronic irritation, traumatic epithelial elements implantation, heredity, immunologic privileged site, co-carcinogen, ultraviolet rays, initiation and promotion and environmental and genetic interaction theories have been reported to explain the malignant transformation. 4
In this case, you can read this article
http://www.tandfonline.com/doi/abs/10.1080/23809000.2016.1162660
Fungating breast cancer and other malignant wounds: epidemiology, assessment and management. Sok Yuen Beha, Leong Chai Leowb. 137-144
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