The term “fungating” describes a condition of ulceration and proliferation that arises when malignant tumor cells infiltrate and erode the barrier properties of the skin, Kalinski et al. (2005). Tumor infiltration of the skin involves the spread of malignant cells along pathways that offer minimal resistence between tissue planes, along small blood vessels, lymphatic vessels and in perineural spaces, Ivetic et al. (1990). Fungating wounds may develop on a number of sites, the breast being the most common, Grocott (2000).

Wound closure is often viewed as the most important end-point in a patient's treatment. However, in certain patients this may not be a realistic option. Palliative care goals work in tandem with those aimed at complete wound closure, addressing objectives focused on the quality-of-life issues for both the patient and family, Alvarez, (2005). The importance of coping with wound odor and high levels of exudate are often the most important objectives in caring for this type of patient.

The poster presentation will detail the case history of 56 year old lady who presented to the Primary Care Physician with a six month history of an extensive fungating breast tumour which she had concealed from her husband and family. Optimum wound management involved the use of a sliver-coated antimicrobial barrier dressing* to deal with any critical colonization of the wound and a hydrocellular polyurethane foam dressing# for exudate management. Healing was never an option with this patient, rather to improve her quality of life and to allow her to live life to the optimum.