LAUSR

BACKGROUND The prevalence of bleeding episodes in malignant wounds (MW) is poorly documented, with no distinction between minor and potentially severe bleedings. This affects the quality of care. METHODS Retrospective study conducted from the medical records of patients followed by the Research and Wound Care Unit from Curie Institute (Paris, France), between 2017 and 2018. Patients > 18 years of age, seen at least once by the Unit and with a MW > 10cm2 were included. FINDINGS 90 patients were included, 74.4% female and 25.6% male, with a median age of 64 years [32-92]. The most frequent etiologies were breast cancer (52.2%), sarcomas (12.2%), squamous cell carcinoma ENT (11%) and pelvic cancer (8.9%). The median survival of patients after their first consultation was 5.6 months [95% CI: 4.6 - 8.4]. Minor bleedings were observed in 38.9% of situations. Bleedings were significantly higher in malignant fungating wounds (p < 0.01). They were treated by the application of alginate or non-adherent dressings. The presence of at least one minor bleeding significantly increased the risk of more severe bleedings (p < 0.001). Hemorrhagic episodes were reported in 18.9% of patients, and 2.2% of patients died as a result of these bleeding episodes. Hemorrhages were fully controlled by hemostatic dressings in 70.6% of cases. The appearance of bleeding (minor or hemorrhagic) was significantly associated with survival (p < 0.001). INTERPRETATION MWs with bleedings appear to be associated with a poor prognosis and could be a reason for early palliative care even if the patient's general condition is preserved. Palliative care must incorporate wound care skills in order to provide the most appropriate solutions to this anxiety-provoking symptom.