Complementary and alternative therapies for management of odor in malignant fungating wounds: a critical review

Abstract

Malignant fungating wounds (MFWs) affect an estimated 5%-10% of all people with cancer. They have a profound effect on the individual, and their associated symptoms such as bleeding, odor, exudate, and pain cause much distress, anxiety, and social isolation. Odor is cited by patients and clinicians as the worst aspect of such wounds. Strategies to manage odor at the wound site include the use of complementary and alternative therapies. This review aimed to synthesize the current evidence for the use of complementary and alternative therapies in the management of odor in MFWs. No restrictions on date, language, or care setting were applied. Nine databases were searched yielding four papers meeting our criteria. Of the four papers, one was a randomized controlled trial (RCT), and three were case studies. Two papers investigated the use of green tea teabags as a secondary dressing, while others used essential oils either combined with a cream applied directly to the wound or as a secondary dressing. In an RCT, green tea was used as a solution to cleanse the wound followed by the application of green tea teabag as a secondary dressing versus metronidazole powder for the management of odor over 7 days. All patients reported a reduction in odor and physical discomfort, and an improvement in social interaction and appetite, but the difference between groups was not statistically significant. The case studies all reported an improvement in odor management. The use of complementary and alternative therapies in the management of MFW-associated malodor is not supported by evidence from RCTs. Green tea may have potential as a secondary dressing to manage odor. Further research in this area is warranted.