Odourous wound

[nettie01]

Hello All

I'm writing from New Zealand and I really appreciate the help and advice I find in this forum.

We have an elderly man with dementia in our LTC unit and, besides urinating on various pieces of furniture and the floor too he has a malodourous wound on his back.

This has been assessed medically; he's had a course of antibiotics for that. My question for the forum is, what are you using these days for malodourous wounds?

Are charcoal pads still being put onto wounds?

Someone had the idea that "Kitty litter" under the bed may help absorb some odour.

Thanks for any tips.

Netty

PS I will search the posts also, for comments about this topic

[bioniclewoman]

What about Dakin's solution? I'm not a WC nurse, but I have had several patients with wounds that smelled so bad they were smelling up the whole hall way or even the whole unit. The WC nurse is usually able to stop the smell by using the Dakin's to clean the wound and usually either making a wet to dry with Dakin's soaked gauze or packing the wound with the Dakin's soaked gauze (if it is deep). The WC nurse usually makes the dressing changes for these stinky wounds BID or at least Q day. Don't forget to use air freshener after the dressing change and take out the trash at the same time.

[nettie01]

Thanks a lot! not sure what Dakin's solution is but I will look up the generic name.

[Peetz, BSN]

First, you have to ask yourself, why is it stinky? Necrosis? Infection? Yeast? That needs to be treated first. Debridement, different antibiotics, anti-fungal cream. Dankins is good but you can only use it for a short period of time. If the odor continues the would should be cultured again to find out why. Charcoal dressings are great for odor absorption too. I also use Hydraphera blue to control odor in wounds. The other advice give, i.e change bandage frequently, remove all garbage after change, is also a must in controlling odor.

[followyourbliss]

Nettie01,

Re: Malodorous wounds: It is in an atypical location: how long has it been there, and, has it been biopsied? Does it present with signs and symptoms of a Neoplastic process? ( cancerous). ie Friable, painful, raised, atypical borders, foul odour, lost of exudate, increased size, etc etc. How deep is it as well? That steers dressing changes and selection.

The combination of a barrier cream to peri wound to protect from excess drainage may be incorporated in addition to using both

a charcoal dressing for odour and absorption, along with a broad spectrum anti microbial such as Iodosorb, Inadine, a Silver based dressing etc. An absorbent pad as well.

Perhaps a consultation with the Dr again.... when wounds fail to respond to a course of antibiotics, various treatments such as creams, etc we want to look at what pathology is underscoring the wound.

Keep us posted! I know dealing with wounds when people are affected by dementia poses its own challenges :)

Warm regards,

Follow Your Bliss

[amoLucia]

Can't help you with actual wound care. But for odor control, we put about 3 cups of fresh coffee grounds into a plate under the bed.

Coffee fragrance really masked the wound odor of our pt.

[NC29mom, ASN, LPN, RN]

Flagyl Flagyl Flagyl. ....topically to wound bed. comes in a gel. Nothing works better.

[tktjRN]

Flagyl Flagyl Flagyl. ....topically to wound bed. comes in a gel. Nothing works

NC29mom, would flagyl be applied directly to the wound then use current tx over it?

[NC29mom, ASN, LPN, RN]

Absolutely. ..apply gel to wound bed or impregnate gauze with gel and pack....depending on what kind of wound/dressing. ...

You can also use tablets. Crush and sprinkle over wound bed. I must add however, I was taught this is not an accepted practice (when I got certified in wound care)....but it's done ALL THE TIME. Just make sure the order specifically says the med is being crushed and applied to bed.

I've used both methods. I try to always use the gel....but....with heavily exudating wounds adding more moisture with a gel is just not ideal.

I had a pt once with very foul fungating wound in which I used Flagyl gel and Flagyl systemically with awesome results. Sometimes it takes both routes to manage the odor.

Poly mem foam is also awesome! I've not been impressed with charcoal dressings in the past. If the wound is draining a lot....you could also pouch & use the odor elimination products in the pouch. I've had awesome success with that as well.

Good luck and let us know how it goes!

[tktjRN]

NC29mom,

Just for clarification. The flagyl gel would be the primary treatment? Could you just use it for Odor control and then apply( for example) prisma dressing over it?

What kind of pouch? If I have a sacral wound, with a large amount of drainage and dressing needs to be changed tid how would I apply the pouch. I'm thinking, your talking about a colostomy pouch..

Thanks I appreciate it!!!!!!