Chronic wound malodour as a hidden burden in community nursing practice

Chronic wounds frequently produce malodour because of bacterial colonisation, necrotic tissue and the metabolic by-products of bacteria, significantly impacting patient quality of life and community nursing care. This article reviews the causes of wound odour and evaluates current management strategies, including the use of activated charcoal dressings, topical antimicrobials like metronidazole, silver, iodine, honey and polyhexamethylene biguanide. These treatments vary in mechanism and effectiveness depending on wound characteristics, such as exudate level and infection status. Subjective odour assessment tools remain standard in clinical practice, though emerging technologies such as gas chromatography and electronic noses show promise for objective analysis. Successful odour management involves addressing the underlying wound pathology alongside treating symptoms to improve patient comfort and improve the environment for the caregiver. Despite advances in wound dressings and understanding, complete odour control remains elusive, necessitating a multidisciplinary and patient-centred approach.