Therapeutic Management of Malignant Wounds: An Update
Adelina-Gabriela Niculescua b, Mihaela Georgescua c, Ioana Cristina Marinașa d✉, Cem Bülent Üstündağe, Gloria Simona Berteșteanuf, Mariana Pintealăg h, Stelian S. Maierg h i, Cristina Maria Al Matarneha g, Marian Angheloiuj, Mariana Carmen Chifiriuca k l
- aDepartment of Microbiology and Immunology, Faculty of Biology, Research Institute of the University of Bucharest, University of Bucharest, Bucharest, Romania
- bDepartment of Science and Engineering of Oxide Materials and Nanomaterials, National University of Science and Technology Politehnica Bucharest, 011061, Bucharest, Romania
- cDepartment of Dermatology, Dr. Carol Davila Central Military, Emergency University Hospital, Bucharest, Romania
- dDepartment of Microbiology and Immunology, Faculty of Biology, Research Institute of the University of Bucharest, University of Bucharest, Bucharest, Romania. ioana-cristina.marinas@icub.unibuc.ro
- eDepartment of Bioengineering, Faculty of Chemical and Metallurgical Engineering, Yildiz Technical University, Istanbul, Turkey
- fENT Department, University of Medicine and Pharmacy Carol Davila and Coltea Clinical Hospital, 020022, Bucharest, Romania
- gCentre of Advanced Research in Bionanoconjugates and Biopolymers, "Petru Poni" Institute of Macromolecular Chemistry, Iasi, Romania
- h
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Abstract
Malignant fungating wounds (MFW) are severe skin conditions generating tremendous distress in oncological patients with advanced cancer stages because of pain, malodor, exudation, pruritus, inflammation, edema, and bleeding. The classical therapeutic approaches such as surgery, opioids, antimicrobials, and application of different wound dressings are failing in handling pain, odor, and infection control, thus urgently requiring the development of alternative strategies. The aim of this review was to provide an update on the current therapeutic strategies and the perspectives on developing novel alternatives for better malignant wound management. The last decade screened literature evidenced an increasing interest in developing natural treatment alternatives based on beehive, plant extracts, pure vegetal compounds, and bacteriocins. Promising therapeutics can also be envisaged by involving nanotechnology due to either intrinsic biological activities or drug delivery properties of nanomaterials. Despite recent progress in the field of malignant wound care, the literature is still mainly based on in vitro and in vivo studies on small animal models, while the case reports and clinical trials (less than 10 and only one providing public results) remain scarce. Some innovative treatment approaches are used in clinical practice without prior extensive testing in fungating wound patients. Extensive research is urgently needed to fill this knowledge gap and translate the identified promising therapeutic approaches to more advanced testing stages toward creating multidimensional wound care strategies.