A Comprehensive Review of Topical Odor-Controlling Treatment Options for Chronic Wounds.
Alma Akhmetova, Timur Saliev, Iain U Allan and 3 others
PMID 27684356WHAT IT FOUND
Wound odor control has little strong evidence.
Charcoal, metronidazole gel, silver, honey, and sugar may reduce smell in small studies, but most odor scores were subjective and short-term, so no option is proven best.
Key findings
01Most wound-odor studies were observational and measured odor as a secondary outcome, so evidence for topical treatments remains limited.
02Topical metronidazole was the most studied odor intervention, with reports of odor reduction or elimination, but its use for wound odor is off-label and evidence comes from small studies and a few randomized trials.
03Charcoal was the most often used and perceived most effective strategy in a survey, but fewer than 50% of respondents considered charcoal products effective and the cited studies did not quantify odor reduction.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The review included many nonrandomized studies, case reports, case series, and small studies with short follow-up. Odor was often a secondary outcome rather than the main measure of treatment effect. Most studies used subjective odor ratings, and few used validated instruments or objective odor measurement. Charcoal studies did not report the magnitude of odor reduction. The clinician survey reported perceived effectiveness and use, not tested efficacy. Metronidazole use for wound odor is off-label and may be limited by availability, cost, and prescription requirements.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not read the high success rates for metronidazole or charcoal as proof that these treatments work. The review says evidence is limited, most studies were small or observational, odor was often a secondary outcome, and odor was usually judged subjectively.