Topical treatment for bleeding oncologic wounds in breast cancer patients: a systematic review




Wounds and Injuries; Breast Neoplasms; Therapeutics.


Objective: To analyze the main clinical evidence about topical treatment for bleeding oncologic wounds in breast cancer patients. Methodology: This is a systematic review carried out using the PRISMA method, in the electronic databases PubMed, Scopus and Web of Science, using the following descriptors: “breast neoplasms”, “breast cancer”, “wounds and injuries”, “malignant fungating wounds”, “malignant wounds” and “bleeding”. Full texts, available in Portuguese, English or Spanish, published between January 2010 and June 2022 were included. In addition to these factors, inclusion criteria were defined as primary studies that investigated treatments, interventions or any topical measures to control bleeding from oncologic wounds in adult patients (≥ 18 years) with breast cancer. Results: 06 articles made up the final sample of this study, with a higher frequency of publication in 2012 (n: 02). Participants in the primary studies reviewed underwent 12 different types of topical treatments, which included hemostatic coatings, non-adherent coatings, vasoactive medication, and cauterizing substances. Overall, all studies reported therapeutic success in relation to the specific forms of treatment employed. Conclusion: Current evidence shows therapeutic success in bleeding oncological wounds from the topical application of several products. However, the results should be interpreted with caution, given the low level of evidence presented by the studies.

Author Biographies

Cynthia Lopes Ferreira, Faculdade de Ciências Humanas de Olinda

Enfermeira pela Faculdade de Ciências Humanas de Olinda (FACHO).

Karoliny Alves Pereira, Centro Universitário de João Pessoa

Enfermeira pelo Centro Universitário de João Pessoa (Unipê)

Mariana Silva Vasconcelos dos Santos, Centro Universitário Brasileiro

Enfermeira pelo Centro Universitário Brasileiro (Unibra)

Etiene Alves de Santana Uchôa, Universidade Católica de Pernambuco

Graduanda de Enfermagem pela Universidade Católica de Pernambuco (UNICAP)

Polyana Alves Bernardino, Universidade Católica de Pernambuco

Enfermeira pela Universidade Católica de Pernambuco (UNICAP)

Vitória Campos dos Santos, Universidade Salvador

Graduanda em Enfermagem pela Universidade Salvador (UNIFACS)

Rayane Gomes de Barros, Centro Universitário Brasileiro

Enfermeira pelo Centro Universitário Brasileiro (UNIBRA)

Thaysa Rafaela Lima da Silva, Centro Universitário Estácio do Recife

Enfermeira pelo Centro Universitário Estácio do Recife

José William Araújo do Nascimento, Universidade Federal de Pernambuco

Enfermeiro pela Universidade Católica de Pernambuco (UNICAP), Especialista em Anatomia Humana pela UNINTER, Mestre e Doutorando em Informática Médica pela Universidade Federal de Pernambuco (Cin-UFPE).


Almeida, G. L., Nascimento, J. W. A., Souza, M. A. O., Santos, B. G. G., Roque, G. S. L., & Santos, I. C. R. V. (2020). Termo adequado para feridas resultantes de processos oncológicos: uma revisão integrativa. Revista Nursing, 23(267), 4478-4481.

Ausen, K., Hagen, A. I., Østbyhaug, H. S., Olafsson, S., Kvalsund, B. J., Spigset, O., et al. (2020). Topical moistening of mastectomy wounds with diluted tranexamic acid to reduce bleeding: randomized clinical trial. BJS Open. 4(2), 216-224.

Brasil. Ministério da Saúde (MS). (1998). Lei no 9.610, de 19 de fevereiro de 1998, que altera, atualiza e consolida a legislação sobre direitos autorais e dá outras providências. Diário Oficial da União. Brasília: Ministério da Saúde.

Choate, E. A., Nobori, A., & Worswick, S. (2019). Cutaneous metastasis of internal tumors. Dermatol Clin. 37(4), 545–554.

Finlayson, K., Teleni, L., & Mccarthy, A. L. (2017). Topical opioids an antimicrobials for the management of pain, infection, and infection-related odors in malignant wounds: a systematic review. Oncol Nurs Forum. 44, 626-662.

Fromantin, I., Watson, S., Baffie, A., Riva, A., Falcou, M. C., & Kriegel, I. (2014). A prospective, descriptive cohort study of malignant wound characteristics and wound care strategies in patients with breast cancer. Ostomy Wound Manage. 60(6), 38-48.

Kakimoto, M., Tokita, H., Okamura, T., & Yoshino, K. (2010). A chemical hemostatic technique for bleeding from malignant wounds. J Palliat Med. 13(1), 11-13.

Monleón-Just, M., Garcia, Y. R., Ruiz-López, D., Borrego, A. S., Crespo, A. A., Jiménez, G. C., et al. (2012). Care in the deterioration of skin integrity due to ductal carcinoma. Palliat Med. 19(4), 155-159.

Nascimento, J. W. A., Santos, R. S., Santos, T. M. R., Silva, A. L. B., Rodrigues, L. D. C., Silva, V. W., et al. (2021). Complications associated with intimate partner violence in pregnant women: a systematic review. Int. J. Dev. Res. 11(7), 48924-48928.

Nielsen, J., & Fogh, K. (2015). Clinical utility of foam dressings in wound management: a review. Chronic Wound Care Management Res. 2, 31-38.

Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., et al. (2021). The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 372:n71.

McHugh, M. L. (2012). Interrater reliability: the kappa statistic. Biochemia Medica. 22(3), 276-282.

Meaume, S., Fromantin, I., & Teot, L. (2013). Neoplastic wounds and degenerescence. J Tissue Viability. 22(4), 122–130.

Merz, T., Klein, C., Uebach, B., Kern, M., Ostgathe, C., & Bükki, J. (2011). Fungating wounds - Multidimensional challenge in palliative care. Breast Care. 6, 21-24.

Pati, D., & Lorusso, L.N. (2018). How to Write a Systematic Review of the Literature. HERD. 11(1), 15-30.

Pereira, J., & Phan, T. (2004). Management of bleeding in patients with advanced cancer. Oncologist. 9(5), 561-570.

Qiu, J. M., & DelVecchio Good, M. J. (2021). Making the best of multidisciplinary care for patients with malignant fungating wounds: a qualitative study of clinicians’ narratives. Palliat Med. 35, 179–187.

Santos, A. S. O., Mesquita, A. C., Silva, A. M. C. R., Paiva, F. M. S. N., Nascimento, C. T., & Peres, L. M. V. (2022). Aspectos fisiopatologicos das feridas neoplasicas: revisão de escopo. Research, Society and Development. 11(3), e58711326832.

Seaman, S., & Bates-Jensen, M. (2015). Skin disorders. Malignant wounds, fistulas, and stomas. Oxford Textbook of Palliative Nursing (4ª ed), Oxford University Press, Nova York.

Simman, R., Reynolds, D., & Saad, S. (2013). Bedside bleeding control, review paper and proposed algorithm. J Am Coll Clin Wound Spec. 4(2), 40-44.

Stillwell, S., Fineout-Overholt, E., Melnyk, B. M., & Wiliamson, K. M. (2010). Evidence– based practice: step by step. Am J Nurs; 110(5), 41-47.

Tilley, C., Lipson, J., & Ramos, M. (2016). Palliative Wound Care for Malignant Fungating Wounds: Holistic Considerations at End-of-Life. Nurs. Clin. N. Am. 51, 513–531.

Tilley, C. P., Fu, M. R., Cleeve, J. V., Crocilla, B. L., & Comfort, C. P. (2020). Symptoms of Malignant Fungating Wounds and Functional Performance among Patients with Advanced Cancer: An Integrative Review from 2000 to 2019. J Palliat Med. 23(6), 848-862.

Tsichlakidou, A., Govina, O., Vasilopoulos, G., Kavga, A., Vastardi, M., & Kalemikerakis, I. (2019). Intervention for symptom management in patients with malignant fungating wounds - a systematic review. J BUON. 24(3), 1301–1308.

Tsukada, T., Nakano, T., Matoba, M., Matsui, D., & Sasaki, S. (2012). Locally advanced breast cancer made amenable to radical surgery after a combination of systemic therapy and Mohs paste: two case reports. J Med Case Rep. 6, 360.

Uebach, B., Krull, E., Simon, S. T., Bausewein, C., Voltz, R., Doll, A., et al. (2022). Guideline-based Care for patients with malignant lesions : The new S3 guideline for patients with incurable cancer. HNO. 70(3), 167-178.

Vardhan, M., Flaminio, Z., Sapru, S., Tilley, C. P., Fu, M. R., Comfort, C., et al. (2019). The Microbiome, Malignant Fungating Wounds, and Palliative Care. Front. Cell. Infect. Microbiol. 9, 373.

Verdon, A. (2015). Fungating wounds: causes, characteristics and impact on patients. Wound Essentials. 10(2), 60-63.



How to Cite

FERREIRA, C. L.; PEREIRA, K. A.; SANTOS, M. S. V. dos .; UCHÔA, E. A. de S.; BERNARDINO, P. A.; SANTOS, V. C. dos .; BARROS, R. G. de .; SILVA, T. R. L. da .; NASCIMENTO, J. W. A. do . Topical treatment for bleeding oncologic wounds in breast cancer patients: a systematic review. Research, Society and Development, [S. l.], v. 11, n. 11, p. e506111133942, 2022. DOI: 10.33448/rsd-v11i11.33942. Disponível em: Acesso em: 6 oct. 2022.



Health Sciences