Early identification of wound infection: understanding wound odour
Abstract
Malodorous wounds can be distressing for patients and their families, negatively impacting on quality-of-life outcomes. For health professionals malodorous wounds can also cause distress manifesting in feelings of disgust when faced with a wound emitting an unpleasant or repulsive odour. There has been investigation into the management of controlling odour particularly in relation to fungating wounds. However, there is limited research that explores techniques for early identification and recognition of wound odours that may be indicative of infection. Electronic nose technology has received some attention, but to date has not been integrated into either diagnostics of infection in wounds or education of health professionals to prepare them for the realities of clinical practice.
Much like our other senses, the sense of smell is a tool for survival in the most primitive manner. Good odours may signal that food is nearby, or that a mating partner is close. Bad smells, in contrast, can signal danger— for example, toxicity or that the food is rotten. Our response to smells, and the smell of wounds in particular, is essentially driven by these primitive instincts. This paper presents an overview of the literature concerning early detection of wound infection through odour. The following literature search methodology1 was used to compile existing knowledge regarding wound odours and the potential of early identification of wound infection through malodours.
The databases searched were PubMed, Cochrane, Google Scholar and Google Patents. The search was limited to published literature written in the English language. Search terms were identical for each of the databases and included: ‘wound’, ‘pressure ulcer’, ‘pressure sore’, ‘bedsore’, AND ‘odour’, ‘smell’, ‘malodour’, AND ‘infection’, ‘bacteria’, ‘fungi’, ‘exudate’, OR ‘electronic nose’, ‘e-nose’. All relevant types of clinical articles (e.g. case series studies, case reports, review papers etc.) and all US/European patent/patent applications to-date were analysed. All databases were searched up to January 2017.
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