How to Deal with Odor in Wounds

Odor in wounds can be distressing for both the patient and the caregiver who must care for them. Odor can cause the patient to feel embarrassed or ashamed and may lead them to withdraw from their daily civilities. Patients with foul-smelling wounds are often driven to cover up the odor using various methods which may actually impede wound healing, such as the application of scented creams or too-frequent bathing. In short, malodorous wounds can have a significant impact on the patient’s life, causing depression and poor self-esteem.

Caregiver Challenges

For the caregiver charged with caring for the wound, the task can be an unpleasant one. Wounds may be so foul-smelling that the caregiver becomes ill, making it difficult for the caregiver to perform the arduous task of caring for these wounds. Those who have cared for such wounds know how difficult this can be.

So what can be done to address the issue of foul-smelling wounds? As it turns out, the problem is not a hopeless one.

What Causes Wound Odor?

The breakdown of tissue through tissue death and necrosis is a common cause of odor in wounds. Certain bacteria that colonize wounds and release compounds can also cause odor. For example, Pseudomonas has a characteristic odor, as does Klebsiella. Anaerobes are frequently the culprit of foul odors, and any wound that suddenly becomes foul smelling has likely become colonized with anaerobes.

Many people try to manage odor using deodorizers, ventilation and charcoal dressings, but generally find these methods ineffective.

How Can Wound Odor be Combated?

The most important first step in combating odor is to ascertain the cause, or source, of the odor. The pathogen should be identified where possible. Antimicrobial wound cleansers may be used, but should contain safe ingredients. The wound should be debrided if needed. The following products may be useful:

• Products containing silver
• Products containing polyhexamethylene biguanide
• For systemic infections, topical and systemic antibiotics may be used
• Odor-control dressings, like those containing charcoal, may be used to absorb odor molecules, preventing odor from escaping the dressing
• ŸCyclodextrins are naturally occurring lipids which absorb odor, and work best in a humid environment, making them ideal for heavily exudating wounds
• ŸMetronidazole (flagyl) has also been used to fight odor; when used topically it can eradicate the anaerobes that cause odor. It is easy and convenient, and using Metronidazole topically does not cause the same side effects as using the drug orally can. Several studies have found topical Metronidazole to be an effective odor destroyer.

Chronic Odor in Wounds

The problem of wound odor can be life-altering for the patient who lives with constant foul odor, and can be unpleasant for the caregiver as well. Every effort should be made to identify the cause of the odor. There are several products that may be effective in combating odor.

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References

1. Alvarez, O., Comfort, C., Hernandez, L., Kalinski, C., Laboy, D., McGrinder, B.,
2. Nusbaum, J., & Schnepf, M. (2005) Effectiveness of a topical formulation
3. containing metronidazole for wound odor and exudate control. Wounds,17(4), Pp. 84-90.
4. Fleck, C. Fighting odor in wounds. Advances in Skin and Wound Care, 19(5), pp. 242-245