Management of fungating wounds (Care at end of life)

Management of fungating wounds (Care at end of life)
Bridget is a 42 year old female with extensive metastatic melanoma, diagnosed 5 years ago. The initial lesion to her right lower leg was surgically removed at diagnosis. This was followed by multiple admissions for interferon and radiotherapy for recurrent disease. Bridget presents with a fungating lesion to her left clavicle, protruding two (2) cm vertically from the site. Bridget and her new husband are fully aware of her poor prognosis.
With reference to the literature:
1. Explain the likely pathogenesis and manifestations of this fungating lesion.
2. Describe the possible psychosocial problems that Bridget may encounter in this scenario.
3. Due to the location of lesion and pain, Bridget is unable to tolerate bulky dressings to the site. Justify how you would manage Bridget’s malodorous and bleeding wound.
4. Explore the financial and practical issues that need consideration in preparation for discharge from hospital.
5. Justify appropriate support services that could be referred to in this case.
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