Wound malodorous

A malodorous wound is consistent with an anaerobic infection requiring suitable anaerobe cover such as metronidazole or clindamycin. 

Recently, film dressings impregnated with an antibacterial (silver) for the management of infected wounds or a deodorizer (charcoal) for malodorous wounds have been introduced. 

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. 

M Benbow, Malodorous wounds how to improve quality of life . Community Nurse, 19995(1)43-46. 

K Williams, Malodorous wounds causes and treatments , Nursing and Residential Care, 1999 1(5) 276-85. 

Williams, K. and Griffiths E. (1999) Malodorous wounds causes and treatment . Nurs Residential Care, 1,5,276. 

The use of essential oils to treat malodorous wounds in cancer patients is becoming widespread in maity palliative care units although no formal clinical trials have been conducted as yet. 

Ballard, K., 1999. Prospective Non-Comparative Evaluation of Carbo for the Treatment of Malodorous Wounds. European Tissue Repair Society, Bordeaux. 

Hack, A., 2003. Malodorous wounds - taking the patirait s perspective into account. J. Wound Care 12, 319-321. 

The most effective way of dealing with malodorous wounds is to prevent or eradicate the infection responsible for the odor, for example through the administration of systemic antibiotics or topical antimicrobial agents. If the formation of odor cannot be prevented, it may be necessary to use a dressing that can absorb the smell. Dressings containing activated carbon can be used for the treatment of these malodorous wounds. 

Since the exuding wounds contain a cocktail of proteins, carbohydrates, enzymes, and other ingredients that are closely associated with odor production, they are often a source of obnoxious smells, especially when infection is involved. Wound odors are caused by short-chain organic acids such as n-butyric, n-valeric, n-caproic, and n-caprylic acids produced by anaerobic bacteria, and amines and diamines such as cadav-erine and putrescine that are produced by the metabolic processes of other proteolytic bacteria. Organisms frequently isolated from malodorous wounds include anaerobes such as Bacteroides and Clostridium species, and numerous aerobic bacteria including Proteus, Klebsiella, and Pseudomonas. 

Haughton W, Young T. Common problems in wound care malodorous wounds. Br J Nurs 1995 4(16) 959-63. 

Thomas S, Hay NP. The antimicrobial properties of two metronidazole medicated dressings used to treat malodorous wounds. Pharm J 1991 246 264-6. 

Infection generally is diagnosed when erythema and edema of the surrounding skin, purulent drainage, malodor, or delayed wound healing are present. 

Erythema, edema, and purulent or malodorous drainage at the wound site are manifestations of infected wounds. The patient may be febrile. 

Unlabeled Uses Fire and ant bites, scabies, urethritis, vaginal malodor, vasectomy, wounds... 

The eyelid and adnexal tissues should be carefully examined for the presence of pimcture wounds, tramna, or infectious lesions of the skin. Facial tenderness, nasal discharge, and malodorous breath are signs of paranasal sinusitis. Focal medial canthal tenderness and tearing may indicate acute dacryocystitis. 

Dextranomer has a pore size that produces an exclusion limit of 1000-8000 Da, which precludes the sorption of viruses and bacteria. Micro-organisms are removed from the wound by the capillary action between the beads, a function that is absent from the paste formulation, which however demonstrates a marked increase in absorbing capacity for malodorous elements and pain producing compounds released during the inflammatory response. 

The description of the test apparatus is described elsewher (Thomas et al 1998), and is shown in Fig 1. The apparatus comprises of a horizontal stainless steel plate rig, with a central circular recess of SOmm diameter and 2mm deep. There is a small hole in which the volatile/malodorous test solution is fed via a mechaiucal syriige pump. This is to simulate an exudating wound. The test solution consisting of sodium/calcium chloride solution containing 142 mmol of sodium ions and 2,5mmol of calcium ions as the chloride salts ffhe concentration of which is quoted to be comparable to human serum or wound exudate), 2% diethylamine (odorous volatile) and 10% newborn bovine serum (fatty acids), simulating wound exudate. 

The fluid handling capabilities of a wound dressing product can influence its ability to contain the malodorous test solution and therefore delay the release of the volatiles/odours into the surrounding air. This was demonstrated by the basic wound... 

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. 

Smell reduction with essential oils was rst reported in 2004 by Warnke et al. in 25 malodorous patients with inoperable squamous cell carcinoma of the head and neck. A commercial product containing eucalyptus, grapefruit, and tea tree essential oils (Megabac ) was applied topically to the wounds twice daily. Normal medication apart from Betadine disinfection was continued. The smell disappeared completely within 2-3 days and signs of superinfection and pus secretion were reduced in the necrotic areas. 

Body malodor Athlete s foot Wound infections Allergic reactions Infections Food pathogens... 

Holloway S, Bale S, Harding K, et al. Evaluating the effectiveness of a dressing for use in malodorous, exuding wounds. Ostomy Wound Manage 2002 48(5) 22-8. 

---