Malodorous wounds in palliative care

To manage malodorous wounds in patients with palliative care needs, consider the following strategies:

• Seal the wound dressing to contain odour.
• Use a wound dressing containing activated charcoal, silver, iodine or Manuka honey to help reduce odourAkhmetova, 2016.
• Apply a deodoriser sparingly to the top of the dressing.
• Consider covering the wound with a bag (as with a colostomy) to collect secretions and contain odour.
• Surgical debridement of a florid tumour may reduce odour.
• Mask environmental odours using absorbent granules, air purifiers or essential oils (eg lavender, juniper berry, citrus) via an infuser or oil burnerAkhmetova, 2016.

For odour control of a malodorous wound, considerAkhmetova, 2016Kalinski, 2005:

The commercial gel preparation is recommended; however, crushed metronidazole tablets (mixed with an inert gel) or metronidazole injection (irrigated directly onto wound) may be used if the commercial gel preparation is unavailable. Long-term therapy may be necessary in some patients with palliative care needs.

If odour does not improve with topical metronidazole and infection is suspected, manage as for ulcer and wound infection in the Ulcer and Wound Management guidelines.