Superabsorbent charcoal dressing versus silver foam dressing in wound area reduction: a randomised controlled trial

• • PMID: 35148626

• DOI: 10.12968/jowc.2022.31.2.140

Abstract

Aim: This study aimed to compare the effect of a novel sterile polyacrylate wound pad with activated carbon cloth treatment with a standard non-adhesive hydrocellular foam dressing with silver in reducing wound area.

Method: A multicentre randomised controlled open-label wound-dressing trial was conducted in two wound care outpatient clinics in western Switzerland from November 2018 to March 2020.

Results: A total of 77 successive patients were randomised to receive either a sterile polyacrylate wound pad with activated carbon cloth treatment (n=38) or the standard non-adhesive hydrocellular foam dressing with silver (n=39). Reduction in wound area was the primary outcome, whereas the application period of the dressing, odour, maceration and pain were the secondary outcomes. Wound area was measured at baseline and during each wound dressing change until the dressings were no longer indicated. Wound area reduced faster in the intervention group than in the control group (0.45cm² per day vs. 0.2cm² per day), although the application period was longer in the intervention group compared with the control group (9.5 days vs. 8.1 days). Maceration reduction was more pronounced in the intervention group (-2.07cm²) than in the control group (-0.71cm²). Odour, pain and infection were similar in both groups.

Conclusion: Sterile polyacrylate wound pad dressings with activated carbon cloth reduced the wound area, as well as the maceration area, faster than the non-adhesive hydrocellular foam dressing with silver.

Keywords: diabetes; dressing; foam dressing; infection; maceration; odour; pain; superabsorbent dressing; ulcer; wound; wound area reduction; wound care; wound dressing; wound healing.

A Laboratory Method for Determining Bacterially Formed Odorants and Reducing Odor in Absorbent Incontinence Products

• • PMID: 31651799

• DOI: 10.1097/WON.0000000000000593

Abstract

Purpose: The purpose of this study was to design a laboratory test method to mimic the formation of bacterially formed odorants during the use of absorbent urinary incontinence products. Three odor inhibitors with different modes of action were tested and evaluated.

Methods: Bacterially formed odorants in incontinence products were evaluated by adding a synthetic urine inoculated with a mixture of 4 bacterial strains to product samples cut from the incontinence products. The product samples were incubated in sealed flasks. The odorants that formed in the head space were sampled onto adsorbent tubes and analyzed by gas chromatography. The inhibitory effects of low pH, ethylenediaminetetraacetic acid (EDTA), and activated carbon were then measured.

Results: This technique enabled production of known odorants 3-methylbutanal, guaiacol, diacetyl, and dimethyl disulfide (DMDS) in concentrations of 50 to 600 ng/L in incontinence products. The method was further evaluated by testing 3 types of odor inhibitors; EDTA significantly reduced formation of all 4 odorants (P < .001). Lowering the pH from 6.0 to 4.9 decreased levels of 3-methylbutanal, DMDS, and guaiacol (P < .001); however, diacetyl levels increased (P < .001). Activated carbon significantly reduced the formation of diacetyl, DMDS, guaiacol, and 3-methylbutanal (P < .001).

Conclusions: The technique we developed can be used to evaluate inhibitors with different modes of action to determine odor control in incontinence products. The odorants formed are produced by bacteria and have been identified as key contributors to the odor of used incontinence products. This work can be a step toward establishing a standard in the field of incontinence and odor control; creation of a standard will help the health care sector compare products to be purchased and benefit patients through the development of better products.

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J Wound Ostomy Continence Nurs. Nov/Dec 2016;43(6):598-609.

A Comprehensive Review of Topical Odor-Controlling Treatment Options for Chronic Wounds

• • PMID: 27684356

• • PMCID: PMC5098468

• DOI: 10.1097/WON.0000000000000273

Free PMC article

Abstract

The process of wound healing is often accompanied by bacterial infection or critical colonization, resulting in protracted inflammation, delayed reepithelization, and production of pungent odors. The malodor produced by these wounds may lower health-related quality of life and produce psychological discomfort and social isolation. Current management focuses on reducing bacterial activity within the wound site and absorbing malodorous gases. For example, charcoal-based materials have been incorporated into dressing for direct adsorption of the responsible gases. In addition, multiple topical agents, including silver, iodine, honey, sugar, and essential oils, have been suggested for incorporation into dressings in an attempt to control the underlying bacterial infection. This review describes options for controlling malodor in chronic wounds, the benefits and drawbacks of each topical agent, and their mode of action. We also discuss the use of subjective odor evaluation techniques to assess the efficacy of odor-controlling therapies. The perspectives of employing novel biomaterials and technologies for wound odor management are also presented.

A Comprehensive Review of Topical Odor-Controlling Treatment Options for Chronic Wounds

• • PMID: 27820585

• DOI: 10.1097/WON.0000000000000289

No abstract available

[Dressings for malodorous wounds]

• • PMID: 26763567

• DOI: 10.1016/j.soin.2015.12.007

Free article

Abstract

While sensitivity to odours varies from one individual to another, bad smells can instinctively and uncontrollably induce nausea and revulsion. Different treatment strategies can be implemented. They consist in neutralising the odours, adding more pleasant smells and/or targeting the bacteria. The management of odours remains a complex problem without any universal or single solution. Odour control must not be used as a replacement for adapted hygiene and wound care.

Keywords: charbon; charcoal; composé organique volatil; dressing; odeur; odour; pansement; plaie; volatile organic compound; wound.

Current practice in the management of wound odour: an international survey

• • PMID: 24238490

• DOI: 10.1016/j.ijnurstu.2013.10.013

Abstract

Aim: To determine from a multi-disciplinary and international perspective current practice in the management of wound odour.

Background: Malodour is cited by patients and carers as one of the most distressing and socially isolating aspects of their wounds. The absence of a standardised approach to assessment and management underscores the need to collect baseline data to support guideline development.

Design: On-line survey.

Methods: A study specific questionnaire in English, Spanish, Italian and German was emailed to wound care organisations worldwide, palliative and oncology nursing organisations, and known contacts with a special interest in wound management, for distribution to members between December 2011 and February 2012.

Results: 1444 people from 36 countries responded. 12% assess odour with descriptive words being the most frequent form of assessment. Charcoal and silver based dressings were the most frequently used odour management agents, yet, only 48.4% and 23% respectively reported these as being very effective. Antimicrobial agents were cited as most effective but were not the most frequently used. 8% use aromatherapy oils direct to the wound, and 74% combine a range of dressings to try and manage odour. Odour, pain and exudate management were the greatest wound management challenges facing patients and clinicians. 46.7% of respondents encounter patients with MFW on a monthly basis and 89% agreed there is a need to develop guidelines in this area.

Conclusion: A 'trial and error' approach to odour management exists with low overall satisfaction with current practice. There is a need for research and education on means to assess odour and odour management options.

Keywords: Guidelines; Management; Nursing; Odor; Palliative wound; Wound symptoms.

A prospective, descriptive cohort study of malignant wound characteristics and wound care strategies in patients with breast cancer

• PMID: 24905356

Abstract

Few studies have addressed the effects of dressings on malignant wounds. A 20-month (May 2010 to January 2011) descriptive, prospective cohort study was conducted by the Wound Care Unit of Institute Curie, Paris, France to evaluate the use of various local care procedures and characteristics of malignant wounds. Symptoms and wound management methods were observed over a period of 42 days in 32 patients (all women, mean age 60 years, range 30-96 years, most with infiltrating ductal carcinoma). After cleansing (with either sterile saline or water), a variety of wound treatments were used based on specific wound characteristics, including calcium alginate, hydrocellular, interface, and active charcoal and superabsorbent dressings. Wound size, color (red, pink, black, yellow), periwound condition, surface wound organisms (number of species and quantity), and signs of infection, along with wound-related pain (rated on a verbal rating scale), odor, bleeding (spontaneous or induced), and exudate (rated on a four-level scale as none, slight, moderate, intense) were assessed at baseline and on days 21 and 42 of treatment. The degree to which each symptom was managed was scored as controlled, partly controlled, or not controlled. Mean initial wound size did not change over the evaluation period; most (74%) wounds were characterized as being inflamed. No infectious episodes were observed during the duration of the evaluation. Exudate and bleeding were generally controlled with hemostatic dressings, calcium alginate dressings, or absorbent pads. Odor was not completely controlled with charcoal dressing and was noted to be significantly greater in patients with >105/g bacterial counts and/or with one or more anaerobic bacteria (P = 0.05). At day 0, 13 out of 25 patients (50%) had uncontrolled pain; pain ratings did not change over the course of the study. Clinical research on specific clinical practice (eg, topical morphine for pain) and to assess the comparative efficacy of different care approaches on controlling the local symptoms of malignant wounds is warranted to improve the quality of care, which may affect patient quality of life.

Flatulence on airplanes: just let it go

• PMID: 23463112

Abstract

Flatus is natural and an invariable consequence of digestion, however at times it creates problems of social character due to sound and odour. This problem may be more significant on commercial airplanes where many people are seated in limited space and where changes in volume of intestinal gases, due to altered cabin pressure, increase the amount of potential flatus. Holding back flatus on an airplane may cause significant discomfort and physical symptoms, whereas releasing flatus potentially presents social complications. To avoid this problem we humbly propose that active charcoal should be embedded in the seat cushion, since this material is able to neutralise the odour. Moreover active charcoal may be used in trousers and blankets to emphasise this effect. Other less practical or politically correct solutions to overcome this problem may be to restrict access of flatus-prone persons from airplanes, by using a methane breath test or to alter the fibre content of airline meals in order to reduce its flatulent potential. We conclude that the use of active charcoal on airlines may improve flight comfort for all passengers.

Managing wound odor #218

• PMID: 20963916

No abstract available

A systematic review of topical treatments to control the odor of malignant fungating wounds

• • PMID: 20538188

• DOI: 10.1016/j.jpainsymman.2009.11.319

Free article

Abstract

Context: Malignant fungating wounds (MFW) result from cutaneous infiltration by carcinogenic cells. Fetid odor, profuse exudate, pain, and infection are common symptoms that add to the physical and psychological suffering of patients with MFW. The topical treatment of MFW remains controversial.

Objectives: To collect evidence about topical treatments to control the odor of MFW.

Methods: Fourteen sources of data were used, without restriction in terms of language, period, or study design. The patient, intervention, comparison, and outcome strategy for the development of research questions yielded 334 descriptors related to oncology, MFW, topical treatments, medications, and symptoms of these lesions. Data from the abstracts of these articles were extracted by two independent researchers and decisions were reached by consensus among them. Through an analysis of these abstracts, studies that broached the topic of MFW odor were selected. These studies were analyzed in their entirety and were classified according to quality, levels of evidence, and grade of recommendation.

Results: Of 11,111 studies identified, 325 (2.93%) made reference to the control of some symptoms of MFW by means of topical interventions: 12.4% related to odor, 16.8% to exudate, 17.8% to bleeding, 31.0% to pain, and 22.0% to MFW-related infection. Within the 59 studies that analyzed odor control, seven were clinical trials (35%), five were case series (25%), and eight (40%) were case studies. Eleven topical treatments were identified. Topical metronidazole and Mesalt dressing yielded 2b level of evidence or B grade of recommendation. Activated carbon dressing and curcumin ointment yielded 2c level of evidence or B grade of recommendation. C and D grades of recommendation were observed for seven topical treatments: topical arsenic trioxide, essential oils, green tea extract, hydropolymer dressings, antiseptic solutions, hydrogels, and debridement enzymes. The variety of interventions and of the methodological quality of the studies did not allow for meta-analysis.

Conclusion: Of the 59 studies of odor, 20 fulfilled all the criteria for inclusion. Few studies of high quality were found, and the principal methodological flaws were the design of the studies, the sample size, and the absence of scales to measure odor. Grade B evidence for the treatment of MFW was found with topical metronidazole, Mesalt dressing, activated carbon dressing, and curcumin ointment.

Are biopolymers potential deodourising agents in wound management?

• • PMID: 19827482

• DOI: 10.12968/jowc.2009.18.7.43112

Abstract

Objective: To investigate the odour-adsorbing properties of biopolymers, with a view to using the findings to develop a novel dressing with odour-adsorbing properties.

Method: The odour-adsorbing properties of a selection of biopolymers (aloe vera, tea tree oil, neem oil and manuka honey) and three commercially available dressings containing activated charcoal cloth (ACC) were quantitatively assessed using laboratory test equipment. An aloe vera-containing composite dressing, designed and developed by the authors, was also compared with the ACC dressings.

Results: Aloe vera was the most adsorbent of the biopolymers and a 40% dilution had comparable values to those of the ACC dressings. Furthermore, values for the novel composite dressing were similar to those of the ACC dressings.

Conclusion: The novel composite dressing may be a potential alternative to ACC dressings, and has the added advantages of having antimicrobial properties as well as the ability to promote a moist wound environment. However, more research is needed.

Malodorous fungating wounds: how dressings alleviate symptoms

• • PMID: 18773764

• DOI: 10.12968/bjcn.2008.13.Sup3.29470

Abstract

Fungating wounds are unlikely to heal and therefore, the prime consideration should be the treatment and, where possible, the elimination of symptoms such as malodour. Malodour is the byproduct of bacteria and the fatty acids that are part of necrotic tissue. Application of dressings that block the odour, such as charcoal, or dressings that are antimicrobial, will reduce or remove the malodour that has such a negative effect on the patient's quality of life.

Activated charcoal and baking soda to reduce odor associated with extensive blistering disorders

• • PMID: 18388369

• DOI: 10.4103/0378-6323.39694

Abstract

Background: Skin disease leading to extensive blistering and loss of skin is associated with a characteristic smell. Odor can cause physiologic disturbances such as increase in heart rate and respiratory rate. It can also cause nausea and vomiting and is disturbing to bystanders.

Aims: To test odor reducing capability of activated charcoal.

Methods: In this blinded experimental study we used putrefied amniotic membrane to produce odor and studied the effectiveness of activated charcoal and soda-bi-carbonate to reduce odor.

Results: Statistical analysis with Kruskal Wall's Chi Square Test and Man Whitney U test showed significant reduction of odor using activated charcoal by itself or along with soda-bi-carbonate.

Conclusion: We recommend the usage of activated charcoal with/without soda bicarbonate as an inexpensive practical measure to reduce foul odor associated with extensive skin loss.

Odor Absorbing Hydrocolloid Dressings for Direct Wound Contact

• PMID: 26110309

Abstract

Patients in institutional settings, such as hospitals and nursing homes, often have or acquire chronic wounds such as those resulting from venous insufficiency and pressure ulcers-these wounds can possess a very offensive odor. 1 The most direct way of avoiding or eliminating wound odor is to prevent or eradicate the infection responsible for it.Topical antibiotics, such as metronidazole gel (0.8 w/v) have proved to be quite effective, but can generate resistant organisms. Further, the action of metronidazole can be sluggish; often several days are needed for any infection to be resolved, and meanwhile the odor is still being generated.Thus, in practice, other methods such as charcoal-based dressings are often used with or with-out concomitant antibiotic therapy. Odor absorbing dressings have been marketed in one form or other for many years. During the past decades a number of charcoal based dressings have been introduced into the market. Some of the more current products are Actisorb ® Silver (Johnson & Johnson Medical Ltd, Gargrave, UK), CarboFlex ® (ConvaTec, Princeton, NJ), Carbonet ® (Smith and Nephew Abstract: Charcoal based odor-absorbing dressings for management of odoriferous chronic wounds have been marketed for many years. However, the presence of wound serum deactivates the charcoal and inhibits the adsorption of odor molecules. Charcoal dressings also generally need adjunct fixation to hold them in place. A new series of hydrocolloid adhesives based on cyclodextrins has been developed to provide an alternative technology for the adsorption of chronic wound odors. Dressings incorporating this technology are suitable for direct wound contact. In presence of serum, superior odor absorption with these new materials in comparison with charcoal dressings has been demonstrated in vitro. These new dressings have significant fluid absorption potential, are self-adhesive, and require no additional fixation. Some of the factors affecting performance of these new materi-als in vitro are presented. Comparisons of fluid handling and odor prevention abilities of 3 hydrocolloid dressings, Exuderm OdorShield ® (Medline, Mundelein, Ill) a hydrocolloid dressing containing cyclodex-trins, coded MED 9150H, TegaSorb ® (3M Health Care, St. Paul, Minn), and DuoDerm Extra Thin ® (ConvaTec, Deeside, UK) are made. Preliminary results of the in-vivo performance of the MED9150H product on chronic wounds are also given.

Wound odour: principles of management and the use of CliniSorb

• • PMID: 18524023

• DOI: 10.12968/bjon.2008.17.Sup3.28914

No abstract available

Efficacy of commercial dressings in managing malodorous wounds

• • PMID: 17505396

• DOI: 10.12968/bjon.2007.16.Sup1.27086

Abstract

This paper investigates a novel in vitro method of ascertaining quantitative comparative data on a selection of commercial available odour absorbent wound dressing. The aim of this study is to determine and evaluate quantitative desirable data on the efficiency of odour absorbency along with other comparable physical characteristics of commercial odour absorbent dressings. This study is a part of an ongoing research programme into the design and development of novel odour absorbent dressings for managing malodorous wounds. The study also includes the development of a controlled in vitro test method that simulates a more realistic situation. A selection of commercially available activated charcoal dressings were analysed and tested, and comparative evaluation was carried out and discussed.

Fighting odor in wounds

• • PMID: 16732068

• DOI: 10.1097/00129334-200606000-00007

No abstract available

Pressure ulcers: diagnostics and interventions aimed at wound-related complaints: a review of the literature

• • PMID: 15807753

• DOI: 10.1111/j.1365-2702.2004.01090.x

Abstract

Aims and objectives: To describe the current scientific evidence in the field of diagnostics and treatment of pain, malodour and exudate from pressure ulcers and to give recommendations for practice, based on these findings.

Background: Patients with pressure ulcers are confronted with symptoms of chronic wounds and impaired wound healing. Assessment and treatment of these symptoms have received very little attention.

Design: Systematic literature review.

Methods: Medline, CINAHL, and Cochrane, were searched for studies on pain, malodour and exudate in patients with pressure ulcers.

Results: The McGill Pain Questionnaire, the Visual Analogue Scale and the Faces Rating Scale are useful instruments to assess pressure ulcer related pain. Strong evidence was found to support a positive effect of (dia)morphine. Some evidence was found to support a positive effect of benzydamine gel and Eutectic Mixture of Local Anaesthetic-cream. Wound malodour is subjectively assessed. In a laboratory study, it is proved that activated charcoal is capable of absorbing gas molecules causing malodour. At present, no studies are available on the odour-absorbing capacity of activated charcoal dressings in pressure ulcer patients. Exudate is a symptom of impaired wound healing. The Pressure Sore Status Tool is a valid and reliable instrument for assessing the wound healing process. There is a possible indication that hydrocolloid positively influences healing time because the absorption of exudates is more effective.

Conclusion: Little sound research has been performed on wound-related complaints in patients with pressure ulcers. Nevertheless several recommendations could be made on the present state of the art.

Relevance to clinical practice: Regarding pressure ulcer related pain, this review supports the intervention of local pain relieve in patients with pressure ulcers. Regarding pressure ulcer related odour and exudates, this study identifies the gaps in evidence and research.

Assessment and management of fungating wounds: a review

• • PMID: 15824709

• DOI: 10.12968/bjcn.2005.10.Sup1.17627

Abstract

Fingating wounds always present a management challenge. Not only is it often difficult to manage the physical aspects of the wound - pain, bleeding, exudate and odour - but also the psychological impact of a fungating wound on the patient and their family or carers is often considerable. This review examines current practice in relation to fungating wounds, and emphasizes the central important of assessment, communication and sensitivity in nursing management.

Effectiveness of devices purported to reduce flatus odor

• • PMID: 15667499

• DOI: 10.1111/j.1572-0241.2005.40631.x

Abstract

Objective: A variety of charcoal-containing devices are purported to minimize problems with odoriferous rectal gas; however, the evidence supporting the efficacy of these products is virtually all anecdotal. We objectively evaluated the ability of these devices to adsorb two malodorous, sulfide gases (hydrogen sulfide and methylmercaptan) instilled at the anus.

Methods: Via a tube, 100 ml of nitrogen containing 40 ppm of sulfide gases and 0.5% H(2) was instilled at the anus of six healthy volunteers who wore gas impermeable Mylar pantaloons over their garments. Since H(2) is not adsorbed by charcoal, the fraction of the sulfide gases removed could be determined from the concentration ratio of sulfide gas: H(2) in the pantaloon space relative to the ratio in instilled gas.

Results: Measurements with no device in place showed that subjects' garments removed 22.0 +/- 5.3% of the sulfide gases, and results obtained with each device were corrected for this removal. The only product that adsorbed virtually all of the sulfide gases was briefs constructed from an activated carbon fiber fabric. Pads worn inside the underwear removed 55-77% of the sulfide gases. Most cushions were relatively ineffective, adsorbing about 20% of the gases.

Conclusions: The ability of charcoal-containing devices to adsorb odoriferous rectal gases is limited by incomplete exposure of the activated carbon to the gases. Briefs made from carbon fiber are highly effective; pads are less effective, removing 55-77% of the odor; cushions are relatively ineffective.

Evaluating the effectiveness of a dressing for use in malodorous, exuding wounds

• PMID: 12046487

Abstract

Malodorous, exuding wounds can cause problems for patients in terms of discomfort and social isolation. A prospective, noncomparative, multicenter study was conducted to evaluate the effectiveness of an odor-controlling dressing in the management of patients with chronic and acute exuding, malodorous wounds. Forty-six patients with various malodorous wounds (mean duration prior to study entry of 231.6 weeks) participated in the study. The majority of the patients were > 65 years of age (mean 70.7 years). Wound characteristics, odor, and dressing exudate absorption were assessed at baseline and at every dressing change (total: 348 dressing changes). Overall assessment of the dressing's ability was rated as good or excellent for odor control (91% of patients), exudate management (82%), and overall comfort (86%). Patient and nurse perception of odor were similar. While appropriate treatment to address the cause of exudate and wound odor remains a priority, the results of this study suggest that discomfort and isolation may be reduced through the use of odor-control dressings.

Role of CarboFlex in the nursing management of wound odour

• • PMID: 12170495

• DOI: 10.12968/bjon.2001.10.2.5395

Abstract

Managing wound malodour is one of the most difficult challenges facing healthcare professionals. This article looks at the causes of wound odour, methods of assessment and strategies for management. It examines the structure of CarboFlex odour control dressing manufactured by ConvaTec, its indications for use, application technique and the research that demonstrates its ability to adsorb odour and absorb exudate.

CliniSorb activated charcoal dressing for odour control

• • PMID: 11276639

• DOI: 10.12968/bjon.2000.9.15.5485

Abstract

The potential for charcoal cloth in wound management relates to its well demonstrated ability to adsorb small gas molecules. Charcoal has become increasingly used to contain odour and is especially useful in the management of fungating lesions. This article looks at CliniSorb activated charcoal odour control dressing (distributed by CliniMed) and describes its construction, action and place in wound management.

Odour-absorbing dressings: 2

• PMID: 9791360

No abstract available

Odour-absorbing dressings: 1

• PMID: 9791359

No abstract available

Identification of gases responsible for the odour of human flatus and evaluation of a device purported to reduce this odour

• • PMID: 9771412

• • PMCID: PMC1727181

• DOI: 10.1136/gut.43.1.100

Free PMC article

Abstract

Background/aims: While the social significance of flatus derives mainly from its odour, previous studies have focused on the non-odoriferous components of rectal gas. The aims of the present study were to determine the role of sulphur-containing gases in flatus odour and test the efficacy of a device purported to reduce this odour.

Methods: Flatus was quantitatively collected via rectal tube from 16 healthy subjects who ingested pinto beans and lactulose to enhance flatus output. The concentrations of sulphur-containing gases in each passage were correlated with odour intensity assessed by two judges. Odour intensity was also determined after treatment of flatus samples with zinc acetate, which binds sulphydryl compounds (hydrogen sulphide and methanethiol), or activated charcoal. Utilising gastight Mylar pantaloons, the ability of a charcoal lined cushion to adsorb sulphur-containing gases instilled at the anus of eight subjects was assessed.

Results: The main sulphur-containing flatus component was hydrogen sulphide (1.06 (0.2) mumol/l), followed by methanethiol (0.21 (0.04) mumol/l) and dimethyl sulphide (0.08 (0.01) mumol/l) (means (SEM)). Malodour significantly correlated with hydrogen sulphide concentration (p < or = 0.001). Zinc acetate reduced sulphur gas content but did not totally eliminate odour, while activated charcoal removed virtually all odour. The cushion absorbed more than 90% of the sulphur gases.

Conclusion: Sulphur-containing gases are the major, but not the only, malodorous components of human flatus. The charcoal lined cushion effectively limits the escape of these sulphur-containing gases into the environment.

Odour-absorbing dressings

• • PMID: 9677995

• DOI: 10.12968/jowc.1998.7.5.246

Abstract

This study uses an objective test system that compares the ability of different dressings to prevent the passage of a volatile amine when applied to a wound model under simulated 'in-use' conditions. Five dressings containing activated charcoal were tested by this method, and a low-adherent absorbent dressing was used as a control. Results demonstrate clear differences in the ability of the products to contain the test solution and prevent the loss of the volatile diethylamine into the surrounding air. Products which combine a physical absorbent with a charcoal component show enhanced performance.

Malignant cutaneous wounds: a management protocol

• PMID: 9087066

Abstract

Malignant cutaneous wounds are emotionally traumatic and difficult to manage lesions which occur secondary to infiltration of cancer into the skin. They occur in patients with end-stage disease and are highly exudative, malodorous, and bleed easily. Quality of life is the goal for treatment, which includes radiation, chemotherapy, surgery, and local wound care. Odor is addressed with varying levels of success through wound cleansing, external deodorizers, charcoal-impregnated dressings, topical antimicrobial therapy, and metronidazole. Exudate is managed with highly absorbent dressing materials, topical steroids or hyoscine (a drying agent). Light bleeding is controlled with local pressure and hemostatic dressings; heavier bleeding may require ligation or cauterization. Cosmetic appearance and other psychosocial issues must be assessed on an ongoing basis. Creative dressing techniques can help restore the look of symmetry to the patient's body. Effective wound management, debridement, and antimicrobial therapy can reduce the risk of infection. Wound cleansing, through irrigation or flushing, should not cause pain, further trauma or bleeding. Dressings should maintain a moist wound environment and not traumatize the wound upon removal. A protocol is included which can be individualized to the needs of each patient and addresses assessment, interventions, patient teaching, documentation, and expected outcomes.

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J Mater Sci Mater Med. 2017 Sep 1;28(10):154.

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