Wound Odour: Why It Matters, and What to Do About It
Learn about the challenges and solutions surrounding chronic wound odour in this deep dive. We explore the causes of wound odour in chronic wounds such as pressure ulcers, diabetic foot ulcers, venous leg ulcers and malignant wounds. We also take a look at the profound effects on patient well-being, and the current available treatment strategies. Finally, we highlight the transformative potential of hypochlorous acid (HOCl) solutions to both neutralize malodour and accelerate wound recovery.
It goes without saying that wound care is a crucial hinge pin of our healthcare system. Whether at the acute or non-acute level, the practice of advanced wound care not only aims to ultimately heal the wound itself but it also strives to enhance patients' quality of life while doing so.
One of the most often-overlooked factors in the journey of wound care is odour. Odour can greatly affect patients' physical and psychological well-being¹⁻³. It’s a simple concept, but a very real issue.
Luckily, there are solutions to this problem. In this article we venture to explore the causes and impacts of wound odour, the current therapies for wound odour reduction, and the potential role of hypochlorous acid (HOCl) in treating wound odour.
Understanding Wound Odour
Wound odour is primarily caused by the presence of bacteria breaking down tissue and releasing volatile organic compounds (VOCs) as byproducts¹⁻³. These VOCs, such as amines, sulphur compounds, and fatty acids, contribute to the characteristic foul smell associated with infected or non-healing wounds¹⁻³. The severity of odour can vary depending on factors like wound size, depth, and bacterial load²⁻³.
Impact on Patients' Lives
The presence of malodour in wounds can have significant physical, emotional, and social implications for patients¹⁻³. Physically, it may lead to nausea, loss of appetite, and sleep disturbances ²⁻³. Psychologically, it can cause embarrassment, social isolation, and depression, affecting patients' overall quality of life and mental health⁴⁻⁵. Wound odour may also result in stigmatization, leading to reluctance in seeking medical attention and compliance with treatment⁴⁻⁵.
Patients with exudate leakage and malodour often feel embarrassed, experiencing difficulty in maintaining outward appearance and dignity. Such experiences can in turn lead to patients adopting maladaptive coping strategies, which can sometimes lead to the worsening of wounds…This can also cause patients to feel embarrassment and negative body image, which causes them to retreat from social activities and contact with others, resulting in social isolation…Thus we can see a cycle of physical problems and psychosocial difficulties which can ultimately delay the healing process. |
Therapies for Odour Reduction
Various approaches are employed by wound care professionals to manage wound odour, including wound debridement to remove necrotic tissue and bacteria, antimicrobial dressings, charcoal dressings, topical agents, and systemic antibiotics¹⁻³. However, some of these methods may not always be effective, and others can carry risks of adverse effects or antibiotic resistance¹⁻³. Born from this realization is a need for alternative, safe, and efficacious treatments for odour reduction in wound care.
Addressing Wound Odour with Hypochlorous Acid (HOCl)
In the specialty of wound care, hypochlorous acid (HOCl) has emerged as a promising therapeutic agent. In fact, this is especially true for the management of malodour⁷⁻¹⁰.
HOCl—produced by the mammalian immune response and replicated outside the body through an advanced electrolysis process—has potent antimicrobial properties. Its targeted method of neutralizing bacteria, including antibiotic-resistant strains, does so without harm to healthy tissue which highlights its potential as a key component in wound management protocols⁷⁻¹⁰.
How HOCl Works to Address Odour-Causing Bacteria and Improve Wound Outcomes
To understand why hypochlorous acid (HOCl) is so effective against wound odour, allow us to get technical for a moment.
The HOCl molecule operates through a sophisticated mechanism of action, penetrating bacterial cell membranes to disrupt their structural integrity⁷. This process leads to the denaturation of vital proteins and interference with essential metabolic pathways, ultimately resulting in bacterial demise⁷.
Plus, HOCl's swift (essentially instantaneous) action and minimal cytotoxicity render it an ideal candidate for topical application in wound care, efficiently addressing odour concerns while priming the wound bed for optimal healing⁷⁻¹⁰.
Hypochlorous Acid as an Anti-Inflammatory
Beyond its antimicrobial efficacy, HOCl exhibits anti-inflammatory properties. This is true with naturally produced HOCl in the body, as well as manufactured HOCl applied topically. These anti-inflammatory properties play a pivotal role in mitigating tissue swelling and redness associated with wound healing⁹. This is a multifaceted approach that not only targets odour at its source but also fosters an environment conducive to accelerated wound recovery⁷⁻¹⁰.
As ongoing research continues to unveil the full spectrum of HOCl's therapeutic potential, its integration into standard wound care protocols holds promise for revolutionizing odour management strategies⁷⁻¹⁰. By leveraging the multifaceted benefits of HOCl, clinicians can effectively address malodour concerns while promoting comprehensive wound health and expedited recovery for patients⁷⁻¹⁰.
Final Thoughts
Wound odour can be distressing issue that can significantly impact patients' well-being and quality of life⁴⁻⁵. While various therapies exist for odour reduction in wound care¹⁻³, the emergence of HOCl as a safe and effective solution offers new hope for patients and healthcare providers alike. By harnessing the antimicrobial properties of HOCl, we can not only address malodour but also promote healing and improve outcomes in wound management⁷⁻¹⁰. As research in this field continues to advance, the integration of HOCl-based therapies into standard wound care protocols holds promise for enhancing patient comfort and recovery.
References
- Ousey, K., Roberts, D., & Gefen, A. (2017). Early identification of wound infection: understanding wound odour. Journal of wound care, 26(10), 577-582.
- Gethin, G., Grocott, P., Probst, S., & Clarke, E. (2014). Current practice in the management of wound odour: an international survey. International journal of nursing studies, 51(6), 865-874.
- O’Brien, C. (2012). Malignant wounds: managing odour. Canadian Family Physician, 58(3), 272-274.
- Alves dos Santos, W., dos Santos Claro Fuly, P., Salvador Caldeira dos Santos, M. L., Dutra Souto, M., Marques Reis, C., & Freitas de Castro, M. C. (2017). Evaluation of social isolation among patients with odor in neoplastic wounds: integration review. Journal of Nursing UFPE/Revista de Enfermagem UFPE, 3.
- Upton, D., Upton, P., Upton, D., & Upton, P. (2015). Psychosocial Consequences of Wounds. Psychology of Wounds and Wound Care in Clinical Practice, 1-24.
- Roos, H., & Kana, B. (2022). Secondary intention wound healing using hypochlorous acid dressings: case report. Wound Healing Southern Africa, 15(1), 22-24.
- Wang, L., Bassiri, M., Najafi, R., Najafi, K., Yang, J., Khosrovi, B., ... & Robson, M. C. (2007). Hypochlorous acid as a potential wound care agent: part I. Stabilized hypochlorous acid: a component of the inorganic armamentarium of innate immunity. Journal of burns and wounds, 6.
- Liden, B. A., Center, D. R. P., Reynoldsburg, O. H., Foot, C., & Ankle, C. (2013). Hypochlorous acid: Its multiple uses for wound care. Ostomy Wound Manag, 59, 8-10.
- Gold, M. H., Andriessen, A., Bhatia, A. C., Bitter Jr, P., Chilukuri, S., Cohen, J. L., & Robb, C. W. (2020). Topical stabilized hypochlorous acid: The future gold standard for wound care and scar management in dermatologic and plastic surgery procedures. Journal of cosmetic dermatology, 19(2), 270-277.
- Ragab, I. I., & Kamal, A. (2017). The Effectiveness of Hypochlorous Acid Solution on Healing of Infected Diabetic Foot Ulcers. Journal of Education and Practice, 8(8), 58-71.
LEADING THE WAY IN HOCl FOR HEALTHCARE
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