Pain, Odor, Dignity, Wounds: Management of a complex oncology patient with multiple wounds

Problem:  A 71 year old male presents in ER with malodor and pain associated with cancer chanting he just wants to die. History reveals HTN, DM, kidney transplant, tumor invading tear duct and extensive history of squamous cell carcinoma to upper torso, head, neck, and upper extremities with multiple open lesions including mouth sores.  Patient reports pain of 10 on a scale of 1-10 and wound dressing changes upon admission took more than two hours.

Objectives: 

To clear wound beds of debris, reduce pain¹, control odor, encourage nutrition and reduce risk for further infection

Outcome:  Active leptospermum honey (ALH) was initiated to all areas for debridement², odor reduction³, and antimicrobial properties⁴.  By the third day of treatment with ALH the mouth sores were improving. All areas of debris were beginning to lift from face, orbit, and shoulder.  Pain is improving but remained 8 of 10.  Odor has significantly diminished and visitors are now inclined to freely enter his room.  Patient’s ability to tolerate PO intake improved as mouth sores diminished. Day 9 patient was tolerating activity and had improved pain score of 5.  On day 12 improvements continue with daily dressing changes with ALH and no further odor.   Prior to transfer to rehab on day 15 the time required for dressing changes has been reduced to 30 minutes.  Patient is in great spirits great with pain score of only 3 during dressing change.

Conclusion:  Utilizing ALH has provided patient with pain reduction and odor free wounds.  Regardless of current medical treatments, patients utilizing ALH demonstrate the ability to heal.  Acting as patient advocate is easier when utilizing current wound care knowledge of advanced products and practices.  Having the ability to keep patients comfortable and improve quality of life while sharing practices collaboratively with others is truly rewarding in itself.