Does anyone have experience or tips for treating malodorous wounds?
Have you ever worked with a malodorous wound? We would love to hear about your experience. Let's use this discussion to share our challenges, tips, and successes so we can all help each other with this difficult and common problem.
Views: 211
Replies to This Discussion
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Permalink Reply by Nancy Bryan on -
I don't usually have a significant problem with wound odors, and the solutions already mentioned are appropriate and effective. But I remember one patient in my facility (LTACH) who was dying and her family refused to withdraw life support. She was young (late 30's) with a chronic, progressive disease, incurable disease but a strong heart and she lingered for a long time on a ventilator and tube feeding. We could not prevent her from developing pressure ulcers, nor did anything we do improve them. As they deteriorated, they became very malodorous to the point that the odor eminated into the hallway (I'm trying to put this as professionally and politely as possible). Dakins' solution and charcoal dressings BID helped some, but did not completely eliminate the smell. We were unable to use spray odor eliminators as we are a ventilator hospital. I think Environmental Services obtained a solid room deodorizer which helped a bit.
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Permalink Reply by Laurie Swezey RN, BSN, CWS,CWOCN on -
Sometimes wound odor can certainly be overwhelming, especially when there is so much tissue necrosis. This really difficult situation. That must have been so difficult for the patient's family.
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Permalink Reply by Maria Soriel Penafiel on
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On my experience with malodorous wound, having a C & S done inorder to know whats causing the wound to have a foul odor, as mostly malodorous wound is infected.
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Permalink Reply by Laurie Swezey RN, BSN, CWS,CWOCN on
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I have had success with flagyl and also charcoal dressings. What did you use? Was it effective?
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Permalink Reply by Marie Catherine Pajares Longcob on
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Wound care practices in management of malodorous wounds.
A. Isolate the problems NOT the patient.
1. Cleanse the wound with Sodium Chloride solution and apply with charcoal dressing everyday for the period of one week.
2.Review the wound after a week and then apply silver dressing for a period of two weeks. Frequency of dressing changes every 48 hours. We are happy since we're able to remove the odor.
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Permalink Reply by Laurie Swezey RN, BSN, CWS,CWOCN on
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Hi Marie,
Thanks for the tips.
Laurie
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Permalink Reply by mary downs-last on -
I have used Flagyl with success. Using Flagyl with charcoal dressings over them works well too. Dakin's solution takes care of the immediate solution, but not in the long run.
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Permalink Reply by Laurie Swezey RN, BSN, CWS,CWOCN on
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Hi Mary,
Thank you for the tip. It is important to note that Dakins should only be used for a limited time on infected/devitalized tissue as it is cytotoxic to healthy cells.
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Permalink Reply by Susan Puleo, RN, WCC on -
Just make sure that you are using flagyl designed for wound beds. (Metrogel.. etc). It is unacceptable to crush flagyl and place in a wound bed. It is off-label use and yet I see hear of people doing this. Careful folks.. could get you in hot water.
If you are unable to get metrogel because it is not on your pharmacy formulary, you may ask pharmacy to compound for use in wound bed. They are usually happy to help.
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Permalink Reply by Nancy J Geerdts on
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Hey Susan - I just spoke to one of our pharmacists and he had not heard anything negative about crushing Flagyl for wound beds. How could this get you in trouble? I did not realize we even stocked Metrogel which I will be using in the future but could you let me know about my above question? Thanks for your time, Nancy
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Permalink Reply by Susan Puleo, RN, WCC on
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Nancy. There is absolutely nothing wrong with flagyl in a wound bed. You can not however, just crush it and use it in a wound bed. I just came back from conference and in more than one class, including legal, it was strongly recommended that you don't just crush a pill and place in wound bed. It is considered "off label use" of the drug. Your pharmacist would need to compound the medication. I hope this helps.
Metrogel/Multidex is different than simply CRUSHING a pill.. they are different compounds.. am I corret Dr. McCulloch?
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