Systematic review of topical interventions for the management of odour in patients with chronic or malignant fungating wounds

Gethin, Georgina; Vellinga, Akke; McIntosh, Caroline; Sezgin, Duygu; Probst, Sebastian; Murphy, Louise; Carr, Peter; Ivory, John D.; Cunningham, Stephen; Oommen, A.M.; Joshi, Lokesh; Ffrench, Cathal

doi:10.1016/j.jtv.2022.10.007

Cited by 6 publications

(4 citation statements)

References 20 publications

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“…Wound-related odour has previously been reported by health professionals and patients as a main symptom associated with MFWs (Gethin et al 2014) and as being both a principal source of patient distress and a challenge in wound management (Gibson and Green 2013). Several studies reported evidence on and use of charcoal dressings, silver dressings and topical metronidazole in the management of odour in people with MFW (da Costa Santos et al 2010; Gethin et al2014; de Castro and Santos 2015; Tsichlakidou et al 2019; Gethin et al 2023; O’eill et al 2022). However, there is limited evidence to support the effectiveness of these approaches for the management of odour (Finlayson et al 2017).…”

Section: Discussionmentioning

confidence: 99%

A survey of UK nurses about their care of people with malignant fungating wounds

Pramod,

Dumville,

Norman

et al. 2023

Preprint

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BackgroundMalignant fungating wounds (MFW) are nonhealing wounds affecting people with advanced cancer. There is currently no research evidence on who delivers care for people’s MFW in the UK and what care these professionals deliver. This survey focussed on nurses who deliver care for people with MFW to find out more about their roles and the care they deliver, and to explore perceived barriers and facilitators to delivering care for these wounds.MethodAn online anonymous survey was conducted among nurses who provide wound care for people with MFW across the UK. Study data were collected using Qualtrics XM software and analysed with SPSS.ResultWe received 154 questionnaire responses. Respondents were tissue viability nurses, community nurses and other specialist nurses. The main reported MFW-related management aims were to manage wound odour, exudate, pain and bleeding, and prevention of infection. The top-ranked treatment aim was pain management followed by odour management. The most reported antimicrobial dressing was topical silver, and the non-antimicrobial dressing was superabsorbent. Access to MFW care training is reported as a barrier to providing care to people with MFW as is a lack of local and national guidelines. Availability of dressings, access to training, and good communication processes were reported as facilitators.ConclusionThis is the first study that explored MFW wound care practices in the UK. A range of nurses are involved in care delivery with variations in the treatments used. Lack of access to MFW care training, resources, and standardised guidelines may impede care delivery.

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Section: Discussionmentioning

confidence: 99%

A survey of UK nurses about their care of people with malignant fungating wounds

Pramod,

Dumville,

Norman

et al. 2023

Preprint

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“…Odour is cited by patients and clinicians as one of the most distressing wound symptoms. Such odour is described in vivid and repulsive language and indicates the profound impact it has on the individual [1][2][3] . Terms such as 'rotting flesh', 'nauseating' 'putrid', rotting meat', 'foul' are just some of the descriptors reported in the literature.…”

Section: Introductionmentioning

confidence: 99%

“…Yet, in the survey only 12% of healthcare professionals assessed odour in routine practice. A systematic review of 105 randomised controlled trials related to venous leg ulceration showed that only eight trials assessed odour and of these 38% (n=3) did not provide details on how this was assessed 3,10 . A recent systematic review of topical interventions to manage wound odour reported that of the five studies that met the inclusion criteria, meta-analysis was not possible due in part to different methods of assessment being used and different timing of assessment 3 .…”

Section: Introductionmentioning

confidence: 99%

“…using an electronic nose, olfactometer, gas chromatography separation coupled with a mass spectrometer detector analysis) and/or subjectively (Sniffin's Sticks tests). However, in the wound healing field, current tools are subjective, mainly using scales in numeric format which assesses odour intensity while some use descriptive terms also in a scale format such as distance from the wound when odour is detected 3,9,10 . It should be noted that odour assessment is very subjective due to variation in individuals' abilities and sensitivities to detect smell further compounding the challenges in assessing this in practice.…”

Section: Introductionmentioning

confidence: 99%

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A protocol for a scoping review to identify methods used in clinical practice to assess wound odour

Gethin,

LeBlanc,

Ivory

et al. 2023

HRB Open Res

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Objective: The objective of this scoping review is to map, from wound assessment tools and other literature, the current methods used to assess wound odour in order to answer the following question: Which methods of assessment, validated or otherwise, are currently used in wound assessment tools to assess wound odour? Introduction: Wound assessment includes not only details of the condition of the wound bed but also evaluation of symptoms associated with the wound including that of odour. Odour is cited by clinicians, patients and carers as one of the most distressing wound symptoms. However, there is no consensus on a preferred method to assess odour thus negatively impacting the internal and external validity of many clinical trials and minimising the ability to perform meta-analysis. Eligibility criteria: Any wound assessment tool or framework that includes assessment of wound odour in any wound aetiology and in any care setting. Any systematic or scoping review that includes assessment of wound odour in any wound aetiology and in any care setting. No limits on date of publication or language will be applied. Methods: We will employ the Preferred Reporting Items for Systematic Review and Meta-Analyses extension for scoping reviews (PRISMA-ScR) guidelines for this scoping review and base its structure on the framework proposed by Arksey and O’Malley. Results: A narrative format will summarise extracted data and provide an overview of tools used to assess wound odour. A PRISMA diagram will outline the results of the search strategy. The identified tools will be summarised in table format and stratified according to methods used. Conclusion: The result of this scoping review will be a list of methods used to assess odour in wounds and will be used to inform a subsequent Delphi study to gain consensus on the preferred method to assess wound odour.

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Therapeutic Management of Malignant Wounds: An Update

Niculescu,

Georgescu,

Marinas

et al. 2024

Curr. Treat. Options in Oncol.

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Systematic review of topical interventions for the management of odour in patients with chronic or malignant fungating wounds

Cited by 6 publications

References 20 publications

A survey of UK nurses about their care of people with malignant fungating wounds

A survey of UK nurses about their care of people with malignant fungating wounds

A protocol for a scoping review to identify methods used in clinical practice to assess wound odour

Therapeutic Management of Malignant Wounds: An Update

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