Wound Odours and Effective Management

Coping with wound odours can be extremely challenging and have a profound negative effect on the patient, and their family at time when more support is needed. Wound odour can diminish appetite and activity and when masked with sprays or fragrances can set up an ongoing reminder of the negative wound experience.

Wound odours need to be clearly evaluated as either those coming directly from the wound or the odour of the wound fluid mixed with dressing material which may disappear after the dressing change.If the odour is present after wound cleaning then it is most likely an infection or dead tissue. Some specific bacteria have characteristic odours such as sweet or ammonia-like, other bacteria can create foul odours due to tissue breakdown.

When attempting to identify the cause of wound odours

Three main areas can be examined:

• Infection – Determine type of infection by discussing with your GP who may recommend a swab or biopsy to decide if you need antibiotics or if the wound would benefit from an antimicrobial dressing.

• Necrotic tissue: The action of some dressings can reduce the amount of necrotic tissue in a wound. Offensive smelling tissue can be removed by the nurse or doctor depending on the location, extent and cause. These and other options will need to be discussed with your GP or specialist. If there is no further treatment recommended dressings can be selected to contain discharge and absorb the odour.

• Fistula – An opening or tracking passage deep into the tissue beyond the wound. Fluid can accumulate inside a fistula that may not be noticed on the outside, but a foul odour could be the only indication. Further surgical opinion is needed if this is suspected so it is important to share your concerns with your GP.

In order to control the odour

There are three main areas to be addressed:

• Environmental: Considering products to use inside the room, opening a window to change the air can be effective. Products are available that neutralise odours and kill bacteria chemically. These are available in sprays, gels & drops (deodorisers). Products that absorb the odour (charcoal, kitty litter, sodium bicarbonate) and products that disguise the odour (room fragrances, aerosol scent sprays, essential oils) are also available

• Systemic control: Antibiotic or antifungal medications can be prescribed but careful monitoring is needed to review the effectiveness.

• Topical control: Products can be used directly on top or inside the wound to contain, absorb or reduce odours. Activated charcoal, medical honey and Stomal Therapy appliances or bags can be fashioned around the wound to contain the wound and exudate.

Please note, the information supplied is general in nature. For individual advice on healing wounds, please consult your medical practitioner.