姑息治疗中恶性溃疡伤口评估:一项范围综述

Malignant fungating wounds assessment in palliative care: a scoping review.

作者信息

Nigrelli Daniela, Gambalunga Francesca, Anastasi Giuliano, Peghetti Angela, Durante Stefano, Giusti Martina, Biagioli Valentina, Quirini Silvio, Iacorossi Laura, Latina Roberto

机构信息

Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.

Professional Health Care Services Department, University Hospital Policlinico Umberto I, Rome, Italy.

出版信息

Front Public Health. 2025 Jun 12;13:1602493. doi: 10.3389/fpubh.2025.1602493. eCollection 2025.

Abstract

INTRODUCTION

Malignant fungating wounds (MFWs) are secondary chronic wounds resulting from malignant cell proliferation and migration, compromising skin integrity in patients with cancer. These wounds present a range of signs and symptoms. Although several instruments are used in their assessment, it is still unclear which tool is most appropriate for comprehensive evaluation and wound healing.

AIM

To review the existing instruments for MFW assessment, highlighting their strengths and limitations.

METHODS

A scoping review was conducted following the Arksey and O'Malley framework (2005), the Joanna Briggs Institute guidelines (2020, 2021), and the PRISMA-ScR checklist (2018). The search was performed on four databases: Web of Science, Scopus, PubMed, and EBSCO.

RESULTS

Forty studies were included, describing 22 instruments. They described half targeted general symptoms, and half wound-related signs and symptoms. Four instruments were specifically designed for MFWs, all based on the Malignant Wound Assessment Tool (MWAT). These were: MWAT - Clinical; MWAT- wound bed status; MWAT- Perception; MWAT - Research. However, only the Clinical and Research versions were validated in English, but neither was subjected to psychometric validation, and lacked a comprehensive assessment, such as key symptoms.

CONCLUSION

Despite the existence of specific tools for MFW assessment, a comprehensive, validated, and standardized tool is still lacking. While the Clinical and the Research versions of the MWAT offer a broad assessment of MFWs, they require refinement to address overlooked symptoms and validation in other languages. Establishing standardized, multidimensional measures could enhance clinical decision-making and improve outcomes for patients living with MFWs.

摘要

引言

恶性溃疡伤口(MFWs)是由恶性细胞增殖和迁移导致的继发性慢性伤口,会损害癌症患者的皮肤完整性。这些伤口呈现出一系列体征和症状。尽管在评估中使用了多种工具,但仍不清楚哪种工具最适合进行全面评估和伤口愈合。

目的

回顾现有的MFW评估工具,突出其优点和局限性。

方法

按照阿克西和奥马利框架(2005年)、乔安娜·布里格斯研究所指南(2020年、2021年)以及PRISMA-ScR清单(2018年)进行了范围综述。在四个数据库中进行了检索:科学网、Scopus、PubMed和EBSCO。

结果

纳入了40项研究,描述了22种工具。其中一半描述的是一般症状,另一半是与伤口相关的体征和症状。有四种工具是专门为MFW设计的,均基于恶性伤口评估工具(MWAT)。它们分别是:MWAT - 临床版;MWAT - 伤口床状况版;MWAT - 感知版;MWAT - 研究版。然而,只有临床版和研究版经过了英文验证,但两者都未经过心理测量学验证,且缺乏如关键症状等全面评估。

结论

尽管存在用于MFW评估的特定工具,但仍缺乏一种全面、经过验证且标准化的工具。虽然MWAT的临床版和研究版对MFW提供了广泛评估,但它们需要改进以解决被忽视的症状,并在其他语言中进行验证。建立标准化的多维测量方法可以加强临床决策,并改善患有MFW患者的治疗结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4137/12198178/dfc9a127b914/fpubh-13-1602493-g001.jpg

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