Fungating wounds

Fungating wounds may be caused by primary skin carcinomas, underlying tumors, or via spread from other tissues. The malodor associated with such necrosis is caused by the presence of aerobic and anaerobic bacteria. The wounds rarely heal and require constant palliative treatment, leading to social isolation of the patients and poor quality of life. 

Use of essential oils to reduce the smell of fungating wounds in 13 palliative care patients was detailed by another group the following year. Lavandula angustifolia, M. alternifolia, and Pogostemon cablin essential oils were used alone or in combinations at 2.5%-5% concentrations in a cream base. The treatments were effective (Mercier and Knevitt, 2005). 

Mercier, D., Knevitt, A. 2005. Using topical aromatherapy for the management of fungating wounds in a palliative care unit. 14 497-501. 

Kaltocarb (calcium alginate fibre bonded to a layer of activated charcoal cloth with an outer layer composed of spun bonded viscose, ConvaTec) is indicated for use as a primary dressing in the management of malodorous wounds including fungating carcinomas, leg ulcers, and pressure sores. 

The production of wound odor can represent a major problem for patients and their carers. Wounds most commonly associated with odor production include leg ulcers and fungating lesions of all types. The smeU from these wounds is caused by a cocktail of volatile agents that includes short-chain organic acids, such as n-butyric, n-valeric, n-caproic, and n-caprylic acids produced by anaerobic bacteria, together with a mixture of amines and diamines such as cadaverine and putrescine that are produced by the metabolic processes of other proteolytic bacteria. 

In the wound-management industry where odor control is much required, a new approach was adopted in 1976, when Butcher et al. first described the use of an activated charcoal cloth developed by the Chemical Defence Establishment in Por-ton Down, UK. This material was incorporated into pads containing surgical gauze and water-repellent fabric. When these pads were nsed in the treatment of fungating breast cancer, gangrene, and colostomies, the associated odors were said to be totally suppressed. 

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