Topical crushed morphine tablets for dressing-related pain in a malignant fungating wound in a resource-limited palliative care setting.
Darshak Sanyal, Arun Ghoshal, Anuja Damani et al.
✦ AI-curated · Sources linked
Case in brief
A woman in her 70s with metastatic breast cancer presented with a painful malignant fungating wound in a palliative care unit in India. Despite systemic oral morphine, she experienced significant dressing-related pain. The application of crushed immediate-release morphine tablets directly to the wound during dressing changes resulted in a reduction of pain from 7-8/10 to 3-4/10, improving her tolerance for wound care without local irritation or systemic toxicity over 12 days.
Diagnostic / clinical pearl
Topical application of crushed morphine tablets can effectively manage dressing-related pain in malignant fungating wounds, especially in resource-limited settings.
Why it matters
This case highlights a practical and affordable pain management strategy for palliative care in low- and middle-income countries where compounded medications are unavailable.