The Microbiome and Metabolome of Malignant Fungating Wounds: A Systematic Review of the Literature From 1995 to 2020.
Journal
Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society
ISSN: 1528-3976
Titre abrégé: J Wound Ostomy Continence Nurs
Pays: United States
ID NLM: 9435679
Informations de publication
Date de publication:
Historique:
entrez:
10
3
2021
pubmed:
11
3
2021
medline:
20
7
2021
Statut:
ppublish
Résumé
Malignant fungating wounds (MFWs) afflict up to 14% of patients with advanced cancer. The bacterial community structures of MFW may influence the development and severity of wound symptoms. The purpose of this systematic review was to evaluate existing evidence regarding the relationship between microbiome and symptoms of MFWs. A systematic review of the published literature from January 1995 to January 2020 was conducted. An established quality assessment tool was used to assess the quality of the included studies. We searched 4 major electronic databases and retrieved 724 articles; 7 met inclusion criteria. Seven studies were included; the overall quality of the included 7 studies was ranked as adequate. Findings from the studies provided an incomplete characterization of the microbiome and metabolome of MFW; none included modern genomic technologies. Twenty different species of aerobes and 14 species of anaerobes were identified, with inconsistent identification of biofilms and multi-drug-resistant bacteria. Symptom occurrence increased with the number of bacteria species (P = .0003) and the presence of at least 1 anaerobe (P = .0006) in malignant wound beds. Cancer wound-derived odor was associated with dimethyl trisulfide and 4 fatty acid volatiles. Periwound and moisture-associated skin damage were associated with higher putrescine levels in exudates. Understanding the role of microbiota of MFW in developing or amplifying the severity of wound symptoms is the first step toward development of more precise and effective topical interventions.
Identifiants
pubmed: 33690246
doi: 10.1097/WON.0000000000000749
pii: 00152192-202103000-00005
doi:
Types de publication
Journal Article
Systematic Review
Langues
eng
Pagination
124-135Informations de copyright
Copyright © 2021 by the Wound, Ostomy and Continence Nurses Society.
Déclaration de conflit d'intérêts
The authors declare no conflicts of interest.
Références
Grocott P, Gethin G, Probst S: Malignant wound management in advanced illness: new insights. Curr Opin Support Palliat Care. 2013;7(1):101–105.
Alvarez OM, Kalimski C, Nusbaum J, et al. Incorporating wound healing strategies to improve palliation (symptom management) in patients with chronic wounds. J Palliat Med. 2007;10(5):1158–1189.
Maida V, Corbo M, Doldhykov M, Ennis M, Irani S, Trozzolo L. Wounds in advanced illness: a prevalence and incidence study based on a prospective case series. Int Wound J. 2008;5(2):305–314.
Thomas S. Current Practices in the Management of Fungating Lesions and Radiation Damaged Skin. Bridgend, England: Surgical Materials Testing Laboratory; 1992.
Alexander S. Malignant fungating wounds: Epidemiology, aetiology, presentation and assessment. J Wound Care. 2009;18(7):273–280.
American Cancer Society. Cancer Facts and Figures 2017. https://www.cancer.org/research/cancer-facts-statistics/all-cancer-facts-figures/cancer-facts-figures-2017.html . Accessed December 22, 2017.
Tilley C, Lipson J, Ramos M. Palliative wound care for malignant wounds at end-of-life. Nurs Clin North Am. 2016;48:483–501.
Lookingbill DP, Spangler N, Sexton FM. Skin involvement as the presenting sign of internal carcinoma. A retrospective study of 7316 cancer patients. J Am Acad Dermatol. 1990;22(1):19–26.
Probst S, Arber A, Faithfull S. Coping with an ulcerative breast carcinoma: an interpretive phenomenological study. J Wound Care. 2013;22(7):349–357.
Lawton J. Contemporary hospice care: the sequestration of the unbounded body and “dirty dying.” Sociol Health Illness. 1998;20:121–140.
Tilley CP, Fu MR, Lipson JM. Palliative wound, ostomy, and continence care. In: Ferrell BR, Paice JA, eds. Oxford Textbook of Palliative Nursing. 5th ed. New York City, NY: Oxford University Press; 2019.
Seaman S. Management of malignant fungating wounds in advanced cancer. Semin Oncol Nurs. 2006;22(3):185–193. doi:10.1016/j.soncn.2006.04.006.
Misic AM, Gardner SE, Grice EA. The wound microbiome: modern approaches to examining the role of microorganisms in impaired chronic wound healing. Adv Wound Care (New Rochelle). 2014;3(7):502–510.
Johnson TR, Gomez BI, McIntyre MK, et al. The cutaneous microbiome and wounds: new molecular targets to promote wound healing. Int J Mol Sci. 2018;19(9):2699.
Pommerville J. Fundamentals of Microbiology. 10th ed. Burlington, MA: Jones & Bartlett Learning; 2014.
Fromantin I, Seyer D, Watson S, et al. Bacterial floras and biofilms of malignant wounds associated with breast cancers. J Clin Microbiol. 2013;51(10):3368–3373.
Lund-Nielsen B, Adamsen L, Gottrup F, Rorth M, Tolver A, Kolmos HJ. Qualitative bacteriology in malignant wounds—a prospective, randomized, clinical study to compare the effect of honey and silver dressings. Ostomy Wound Manag. 2011;57(7):28–36.
Shirasu M, Nagai S, Hayashi R, Ochiai A, Touhara K. Dimethyl trisulfide as a characteristic odor associated with fungating cancer wounds. Biosci Biotechnol Biochem. 2009;73(9):2117–2120.
Gethin G. Management of malodor in palliative wound care. Br J Community Nurs. 2011;16:S28–S36.
Tamai N, Akase T, Minematsu T, et al. Association between components of exudates and periwound moisture-associated dermatitis in breast cancer patients with malignant fungating wounds. Biol Res Nurs. 2016;18(2):199–206.
Marchesi JR, Ravel J. The vocabulary of microbiome research: a proposal. Microbiome. 2015;3:2–3. doi:10.1186/s40168-015-0094-5.
Feinstein AR. Symptoms as an index of biological behavior and prognosis in human cancer. Nature. 1966;209(5020):241–245.
Cleeland CS, Bennett GJ, Dantzer R, et al. Are the symptoms of cancer and cancer treatment due to a shared biologic mechanism? A cytokine-immunologic model of cancer symptoms. Cancer 2003;97(11):2919–2925. doi:10.1002/cncr.11382.
Fu MR, McDaniel RW, Rhodes VA. Measuring symptom occurrence and symptom distress: development of the symptom experience index. J Adv Nurs 2007;59(6):623–634. doi:10.1111/j.1365-2648.2007.04335.x.
Lenz ER, Pugh LC, Milligan RA, Gift A, Suppe F. The middle-range theory of unpleasant symptoms: an update. Adv Nurs Sci. 1997;19(3):14–27.
Whittemore R, Knafl K. The integrative review: updated methodology. J Adv Nurs. 2005;52(5):546–553.
Jones KF, Fu MR, Paice J, et al. Exploring long-term opioid use in cancer survivors: an integrative review. J Pain Symptom Manage. 2021;61(2):395–415. doi:10.1016/j.jpainsymman.2020.08.015.
Finlayson C, Yu TC, Fu MR. The impact of patient's awareness of disease status on treatment preferences and quality of life among patients with metastatic cancer: a systematic review from 1997-2014. J Palliat Med. 2015;18(2):176–186.
Grant MJ, Booth A. A typology of reviews: an analysis of 14 review types and associated methodologies. Health Infºo Libr J. 2009;26(2):91–108.
Thuleau A, Dugay J, Dacremont C, et al. Volatile organic compounds of malignant breast cancer wounds: identification and odors. Wounds. 2018;30(11):337–344.
Kuge S, Tokuda Y, Ohta M, et al. Use of metronidazole gel to control malodor in advanced and recurrent breast cancer. Jpn J Clin Oncol. 1996;26(4):207–210.
Fromantin I, Watson S, Baffie A, et al. A prospective, descriptive cohort study of malignant wound characteristics and wound care strategies in patients with breast cancer. Ostomy Wound Manag. 2014;60(6):38–48.
Donlan R. Biofilms: Microbial life on surface. Emerg Infect Dis. 2002:8(9):881–890.
Jamal M, Ahmad W, Andleeb S, et al. Bacterial biofilm and associated infections. J Chin Med Assoc. 2018:81(1):7–11.
Tilley CP, Fu MR, Van Cleave JH, Crocilla BL, Comfort CP. Symptoms of malignant fungating wounds and functional performance among patients with advanced cancer: an integrative review from 2000 to 2019. J Pall Med. 2020:23(6):848–862.