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Palliative Care in the Management of Pain, Odor, and Exudate in Chronic Wounds at the End of Life: A Cohort Study

Kelechi, Teresa J. PhD, RN; Prentice, Margie MBA; Madisetti, Mohan MS; Brunette, Glenda MSN, RN, CWON; Mueller, Martina PhD

Journal of Hospice & Palliative Nursing: February 2017 - Volume 19 - Issue 1 - p 17–25
doi: 10.1097/NJH.0000000000000306
Symptom Management Series

Palliative care approaches that effectively manage distressful symptoms associated with wounds at the end of life remain elusive. This 4-week study examined a topical wound powder RGN107 for reducing pain, odor, and exudate in 50 patients with pressure ulcers, skin tears, and malignant/fungating and vascular wounds receiving hospice or palliative care and explored quality of life for the caregiver. Through an observational design, the outcomes were measured with visual analog scales, 2 pain questionnaires, and a caregiver quality-of-life instrument. Intent-to-treat analyses were used. Statistically significant reductions in pain (P = .001), odor (P = .04), and exudate (P = .00003) were observed. Caregiver quality of life remained unchanged (P = .28); however, improvements were noted in 3 subscales. Findings suggest topical RGN107 reduced pain, odor, and exudate in a highly challenged population with wounds at the end of life. A larger comparative effectiveness trial should be conducted with other wound powder comparators and usual care approaches and should include cost benefits.

Teresa J. Kelechi, PhD, RN, is professor and David and Margaret Clare Endowed Chair, College of Nursing, Medical University of South Carolina, Charleston.

Margie Prentice, MBA, is research manager, College of Nursing, Medical University of South Carolina, Charleston.

Mohan Madisetti, MS, is project director, College of Nursing, Medical University of South Carolina, Charleston.

Glenda Brunette, MSN, RN, CWON, is board-certified wound and ostomy nurse, Department of Specialty Nursing, Medical University of South Carolina, Charleston.

Martina Mueller, PhD, is biostatistician, College of Nursing, Medical University of South Carolina, Charleston.

Address correspondence to Teresa J. Kelechi, PhD, RN, College of Nursing, Medical University of South Carolina, 99 Jonathan Lucas St, MSC 160, Charleston SC 29425 (kelechtj@musc.edu).

This work was funded by the National Institute of Nursing Research (NINR) (award 1R21NR014310-01). The use of REDCap was supported by the National Institutes of Health/National Center for Advancing Translational Sciences (UL1TR000062).

The ideas and opinions expressed herein are those of the authors and not necessarily reflective of the NINR.

The authors have no conflicts of interest to disclose.

© 2017 by The Hospice and Palliative Nurses Association.