title: Morphological characteristics of and factors related to moisture-associated dermatitis surrounding malignant wounds in breast cancer patients.
abstract: OBJECTIVE
  Patients with malignant breast wounds (MBWs) have multiple symptoms. In particular, care for exudates or peri-wound moisture-associated dermatitis (MAD) is difficult. However, MAD has not been distinguished from peri-wound dermatitis. Therefore, care for patients with MAD has not been well established. The aim of this study was to describe morphological characteristics of MAD in MBWs and link morphological characteristics of MAD to related factors.
  
  
  METHODS
  We conducted a qualitative descriptive study and a cross-sectional study. Data were collected by qualitative participant observation and structured interviews. The qualitative descriptive study was conducted using the 'morphoqualitative analysis' method. Data analyses were performed using qualitative research methods. In the cross-sectional study, the participants were classified into 2 groups for comparison: with MAD (MAD group) and without MAD (non-MAD group).
  
  
  RESULTS
  Characteristics of 24 MBWs were examined. Morphoqualitative analyses of data generated 17 subcategories and 3 categories. We could morphologically define MAD by findings of 'radial shape matching the dressing' and 'half-fusiform shape over the dressing'. Regarding factors related to MAD, necrotic tissue type was significantly more severe in the MAD group than in the non-MAD group (p = 0.048). Wound exudate leakage was significantly more frequent in the MAD group than in the non-MAD group (p = 0.013).
  
  
  CONCLUSIONS
  Our study provides several points for nursing MBWs. Morphoqualitative analyses of MAD are quite important for evaluating possible causes of MAD as well as selecting effective interventions.
authors.affiliation: Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan. Electronic address: ntamai-tky@umin.ac.jp.
authors.forename: Nao
authors.initials: N
authors.lastname: Tamai
authors.forename: Motoko
authors.initials: M
authors.lastname: Horii
authors.forename: Kimie
authors.initials: K
authors.lastname: Takehara
authors.forename: Shizuko
authors.initials: S
authors.lastname: Kato
authors.forename: Yuko
authors.initials: Y
authors.lastname: Yamamoto
authors.forename: Ayumi
authors.initials: A
authors.lastname: Naito
authors.forename: Mikiko
authors.initials: M
authors.lastname: Tayama
authors.forename: Yoko
authors.initials: Y
authors.lastname: Tamahashi
authors.forename: Seigo
authors.initials: S
authors.lastname: Nakamura
authors.forename: Takafumi
authors.initials: T
authors.lastname: Kadono
authors.forename: Makoto
authors.initials: M
authors.lastname: Oe
authors.forename: Takashi
authors.initials: T
authors.lastname: Nagase
authors.forename: Hiromi
authors.initials: H
authors.lastname: Sanada
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D003430:Cross-Sectional Studies; D003872:Dermatitis / Q000451:nursing* / Q000473:pathology*; D005069:Evaluation Studies as Topic; D005122:Exudates and Transudates; D005260:Female; D006801:Humans; D007564:Japan; D008408:Mastectomy / Q000009:adverse effects* / Q000379:methods; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000451:nursing / Q000473:pathology; D011379:Prognosis; D012307:Risk Factors; D012720:Severity of Illness Index; D017592:Skin Care / Q000379:methods; D013530:Surgical Wound Infection / Q000209:etiology / Q000451:nursing* / Q000473:pathology*; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology
keywords: Breast cancer; Malignant fungating wound; Nursing; Palliative; Qualitative study; Wound care