Topical treatment for controlling malignant wound odour

Abstract

Background The prevalence of malignant wounds (MWs) is currently unknown. However, it is estimated that around 5%-10% of breast cancer cases, sarcomas and melanomas result in MWs. Aim This study aimed to identify and analyse the scientific evidence on the use of topical treatments for controlling odour from MWs. Methods We used a PRISMA checklist to systematically review articles in the following databases: PubMed, ProQuest, Science Direct, CINAHL, Wiley, Springer, CANCERLIT and Google Scholar, published from 2011 to 2018. We structured the research questions with the use of PICO elements. Although 111 articles were obtained from the search, only eight articles met the inclusion criteria. We analysed these articles with the aid of a CASP checklist and classified them based on the levels of evidence and recommendation grade. Results Among the eight shortlisted articles, four were intervention studies (three RCTs and one non-controlled study), three were case studies and one was a cohort study. The MWs in these articles were predominantly located on the breast, head/neck, cervix, vulva/ vagina, groin, spine, lower limbs, penis and rectum/ anus. Wound odour was measured using the verbal rating scale (VRS). Six products were used as topical therapies to manage wound odour: Polyhexamethylene biguanide, metronidazole, green tea, Manuka honey, nanocrystalline silver nanoparticles and charcoal dressing. These were associated with level of evidence 2b and recommendation grade B. Further, the charcoal dressing was associated with level of evidence 4 and recommendation grade C. Conclusions The following topical therapeutic products for control or management of MW Fodour were of recommendation grade B: polyhexamethylene biguanide, metronidazole, green tea, manuka honey and nanocrystalline silver nanoparticles. Implications for clinical practice The topical products discussed in this review can be used for controlling MW odour. Six interventions in the form of topical therapies were identified to reduce wound odour, namely Polyhexamethylene biguanide, metronidazole, green tea, manuka honey and nanocrystalline silver nanoparticles with level of evidence 2b and recommendation grade B. The use of oral metronidazole as topical therapy in wounds is not recommended, because it shows poor results. It is better to use metronidazole gel proved to be effective and safe for reduce bad odour. [ABSTRACT FROM AUTHOR]