Odour

Odour

Infected wounds and wounds which are necrotic / sloughy can often become malodorous and hence the cause, the infection or the necrotic tissue must be treated to control or remove the odour. Odours are a common feature of many chronic wounds; especially leg ulcers and fungating wounds and some acute wounds; dehisced surgical wounds and contaminated traumatic wounds. Malodour impacts upon the patient’s nutritional status as smell accounts for 85-90% of taste and flavour1.

Control of malodorous wounds can significantly improve a patient’s mental wellbeing and quality of life whilst receiving treatment1. They can be absorbed or eliminated using wound dressings containing activated charcoal such as CliniSorb or by using topical agents. Care should be taken of the surrounding skin as the peri-wound is at risk of maceration or excoriation due to the increased levels of exudate and so barrier preparations, such as LBF should be considered as part of the treatment plan. Systemic antibiotics may be required if the infection is profound. Patients may use aromatherapy oils and / or air fresheners to manage the odour within their environment.

Activated charcoal dressings such as CliniSorb can be used to reduce wound odour. The activated charcoal provides a high surface area to absorb both exudate and any odour that may be present.

Odour presents a major challenge for nurses. It causes significant distress and embarrassment for a patient and their relatives. Aversion to malodour is deeply ingrained in human behaviour. It may lead to social isolation and depression. An odour assessment may be completed to help guide the healthcare professional to the appropriate treatment regime.

Score

Assessment

Very strong

Odour is evident upon entering the room (6 – 10 feet from the patient) with the dressing intact

Strong

Odour is evident upon entering the room (6 – 10 feet from the patient) with the dressing removed

Moderate

Odour is evident at close proximity to the patient when the dressing is intact

Slight

Odour is evident at close proximity to the patient when the dressing is removed

No odour

No odour is evident at close proximity even when the dressing is removed

(Adapted from the Baker in Haig Scale (1993) 2

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References:
1 Van Toller, S. (1994) Invisible wounds: the effects of skin malodours. Journal of Wound Care 3: 2, 103 – 105
2 Baker in Haig Scale in Poteete V (1993) Case study: eliminating odours from wounds Decubitus 6 (4) 43 – 46

Caveat: The information given is a guide only and should not replace clinical judgement.