Comprehensive wound malodor management: Win the RACE

Abstract

Complex wounds that give off a foul odor are common in various patient care settings. Wound malodor has grave effects, both physical and psychological, and its management presents a serious challenge for caregivers. Multiple factors and processes involved in malodor production need to be considered in designing a comprehensive treatment plan described by the acronym RACE: removal of necrotic tissue, antibacterials, odor concealers, and education and support. Improving quality of life is the outcome of winning the RACE against malodor.

Cuidados de enfermagem com feridas neoplásicas

“…English/Portuguese J Nurs UFPE online., Recife, 12(12):3456-63, Dec., 2018 3461 strengthens, then, as an option for the dressings, the applications of absorptive covers. 13 In an international study, the electrochemotherapy technique for effective odor control in patients with malignant neoplasms and advanced cutaneous neoplastic wound, such as melanomas, is cited. Electrochemotherapy is provided in an antitumor therapy in which a non-permeable (ie, bleomycin) or poorly permeable (i.e.…”

“…Odor 13 Removal of necrotic tissue, use of bactericidal (metronidazole gel, silver sulfadiazine, neomycin, honey, yoghurt), control of exudate with nonadherent and absorbent coatings. Use of aromatizers.…”

“…It is verified that the covers help the treatment because they have a bactericidal action and, in clinical practice, it is common the use of toppings with bactericidal actions for the improvement of the odor. The main covers described are listed: metronidazole, on presentation as a gel, cream or tablet (diluted in solution); 16 covers with the presence of silver added to the formula, such as silver sulfadiazine 13,16 and neomycin is also mentioned 13 and activated charcoal 11 as hedging options. As suggested by the authors, natural substances such as honey and yogurt, which, according to the studies, have a bactericidal action, however, these notes come from international studies 13 and are not common in national clinical practice.…”

“…The debridement 13 (removal of necrotic tissue) is also an option, but it must be carefully evaluated by the nurse because of the high risk of bleeding. It is known that neoplastic wounds are widely vascularized and therefore avoid the removal of necrotic tissues strongly adhered to by the high risk of local bleeding.…”

“…Infection control is associated with decreased presence of exudate. For the control of the exudate, absorbent covers such as alginate, polyurethane foam and the dressing consisting of hydrofibrate, 13,16 and some of these coatings have a silver association that assists in the bactericidal action. Another important aspect is exposed, which is the care with the edge of the wound, since the abundant presence of exudate can cause maceration and difficult healing, therefore, one must protect around.…”