[nurselearner]

We have an end stage patient on hospice with a necrotic sacral wound. Pain is well managed and the family does not want aggressive treatment for the wound. She is in LTC and the staff is c/o odor from the wound. Recommendations for dressings, or anything we can use in the wound to neutralize the odor. We already know about charcoal or cat litter under the bed. Anything more direct for the wound?
Thanks for your help.

[a21chdchic]

6-26-2007
There is something that we do in our practice - after dressing the wound, you can sprinkle baking soda on the dressing (only the dressing). This helps a great deal.

Ana

[earle58]

charcoal comes in all forms.
they have pads that you lay directly on the wound bed.

leslie

[adrienurse]

some things I've seen:
Putting a bowl of vinegar or some variety of mint essential oil nearby. It competes with the offending odour.

[HospicePalliativeRN]

Metronidazole (Flagyl) can also be used to control wound odor. This is done by finely crushing the pill form (or by obtaining a canister of Flagyl that is already in powder form) and applying it directly to the wound bed. Metronidazole is also available in gel form. In most cases, this medication has been very effective in decreasing odor and decreasing exudate. See the following link for an article on this:

http://www.woundsresearch.com/article/3950

[blueheaven]

chlorpactin (which smells like weak chlorox) bid or tid dressing. Helps clear out any infection and helps with the odor.

[Candy1798]

I have to agree with the flagyl suggestion. I have seen necrotic and also fungating wounds with terrible odor. Flagyl powder neutralizes the odor and also I have seen it help with the drainage associated with these wound. It comes in many ways, although, I use Flagyl 375mg caps and open them and sprinkle powder directly into wound bed. Another thing that might help would be gauze moistened with acetic acid solution. Good luck!!!

[adrienurse]

help me understand. I'm in no means a wound care nurse.

when I think of gangrene, I think I was told that the objective is to keep the wound bed as dry as possible (eg nothing fluid related besides painting theit with iodine). If the gangrene is wet it spreads more aggressively. Does wet dressings interfere with this?

[bgogal]

crushed flagyl sprinkled on the wound can help control the odor