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Akhmetova A, Saliev T, Allan IU, Illsley MJ, Nurgozhin T, Mikhalovsky S. A Comprehensive Review of Topical Odor-Controlling Treatment Options for Chronic Wounds. J Wound Ostomy Continence Nurs 2017; 43:598-609. [PMID: 27684356 PMCID: PMC5098468 DOI: 10.1097/won.0000000000000273] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The process of wound healing is often accompanied by bacterial infection or critical colonization, resulting in protracted inflammation, delayed reepithelization, and production of pungent odors. The malodor produced by these wounds may lower health-related quality of life and produce psychological discomfort and social isolation. Current management focuses on reducing bacterial activity within the wound site and absorbing malodorous gases. For example, charcoal-based materials have been incorporated into dressing for direct adsorption of the responsible gases. In addition, multiple topical agents, including silver, iodine, honey, sugar, and essential oils, have been suggested for incorporation into dressings in an attempt to control the underlying bacterial infection. This review describes options for controlling malodor in chronic wounds, the benefits and drawbacks of each topical agent, and their mode of action. We also discuss the use of subjective odor evaluation techniques to assess the efficacy of odor-controlling therapies. The perspectives of employing novel biomaterials and technologies for wound odor management are also presented.
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Affiliation(s)
- Alma Akhmetova
- Alma Akhmetova, BSc, Laboratory of Experimental and Clinical Pharmacology and Pharmacy, National Laboratory Astana, Nazarbayev University, Astana, Kazakhstan
- Timur Saliev, MD, PhD, Laboratory of Translational Medicine and Life Sciences Technologies, National Laboratory Astana, Nazarbayev University, Astana, Kazakhstan
- Iain U. Allan, PhD, School of Biomaterials and Biomolecular Sciences, University of Brighton, Brighton, United Kingdom
- Matthew J. Illsley, PhD, School of Biomaterials and Biomolecular Sciences, University of Brighton, Brighton, United Kingdom
- Talgat Nurgozhin, MD, PhD, Laboratory of Experimental and Clinical Pharmacology and Pharmacy, National Laboratory Astana, Nazarbayev University, Astana, Kazakhstan
- Sergey Mikhalovsky, PhD, School of Biomaterials and Biomolecular Sciences, University of Brighton, Brighton, United Kingdom; and School of Engineering, Nazarbayev University, Astana, Kazakhstan
| | - Timur Saliev
- Correspondence: Timur Saliev, MD, PhD, Centre for Life Sciences, Nazarbayev University, Unit 9, 53 Kabanbay batyr Ave, Astana 010000, Kazakhstan ()
| | - Iain U. Allan
- Alma Akhmetova, BSc, Laboratory of Experimental and Clinical Pharmacology and Pharmacy, National Laboratory Astana, Nazarbayev University, Astana, Kazakhstan
- Timur Saliev, MD, PhD, Laboratory of Translational Medicine and Life Sciences Technologies, National Laboratory Astana, Nazarbayev University, Astana, Kazakhstan
- Iain U. Allan, PhD, School of Biomaterials and Biomolecular Sciences, University of Brighton, Brighton, United Kingdom
- Matthew J. Illsley, PhD, School of Biomaterials and Biomolecular Sciences, University of Brighton, Brighton, United Kingdom
- Talgat Nurgozhin, MD, PhD, Laboratory of Experimental and Clinical Pharmacology and Pharmacy, National Laboratory Astana, Nazarbayev University, Astana, Kazakhstan
- Sergey Mikhalovsky, PhD, School of Biomaterials and Biomolecular Sciences, University of Brighton, Brighton, United Kingdom; and School of Engineering, Nazarbayev University, Astana, Kazakhstan
| | - Matthew J. Illsley
- Alma Akhmetova, BSc, Laboratory of Experimental and Clinical Pharmacology and Pharmacy, National Laboratory Astana, Nazarbayev University, Astana, Kazakhstan
- Timur Saliev, MD, PhD, Laboratory of Translational Medicine and Life Sciences Technologies, National Laboratory Astana, Nazarbayev University, Astana, Kazakhstan
- Iain U. Allan, PhD, School of Biomaterials and Biomolecular Sciences, University of Brighton, Brighton, United Kingdom
- Matthew J. Illsley, PhD, School of Biomaterials and Biomolecular Sciences, University of Brighton, Brighton, United Kingdom
- Talgat Nurgozhin, MD, PhD, Laboratory of Experimental and Clinical Pharmacology and Pharmacy, National Laboratory Astana, Nazarbayev University, Astana, Kazakhstan
- Sergey Mikhalovsky, PhD, School of Biomaterials and Biomolecular Sciences, University of Brighton, Brighton, United Kingdom; and School of Engineering, Nazarbayev University, Astana, Kazakhstan
| | - Talgat Nurgozhin
- Alma Akhmetova, BSc, Laboratory of Experimental and Clinical Pharmacology and Pharmacy, National Laboratory Astana, Nazarbayev University, Astana, Kazakhstan
- Timur Saliev, MD, PhD, Laboratory of Translational Medicine and Life Sciences Technologies, National Laboratory Astana, Nazarbayev University, Astana, Kazakhstan
- Iain U. Allan, PhD, School of Biomaterials and Biomolecular Sciences, University of Brighton, Brighton, United Kingdom
- Matthew J. Illsley, PhD, School of Biomaterials and Biomolecular Sciences, University of Brighton, Brighton, United Kingdom
- Talgat Nurgozhin, MD, PhD, Laboratory of Experimental and Clinical Pharmacology and Pharmacy, National Laboratory Astana, Nazarbayev University, Astana, Kazakhstan
- Sergey Mikhalovsky, PhD, School of Biomaterials and Biomolecular Sciences, University of Brighton, Brighton, United Kingdom; and School of Engineering, Nazarbayev University, Astana, Kazakhstan
| | - Sergey Mikhalovsky
- Alma Akhmetova, BSc, Laboratory of Experimental and Clinical Pharmacology and Pharmacy, National Laboratory Astana, Nazarbayev University, Astana, Kazakhstan
- Timur Saliev, MD, PhD, Laboratory of Translational Medicine and Life Sciences Technologies, National Laboratory Astana, Nazarbayev University, Astana, Kazakhstan
- Iain U. Allan, PhD, School of Biomaterials and Biomolecular Sciences, University of Brighton, Brighton, United Kingdom
- Matthew J. Illsley, PhD, School of Biomaterials and Biomolecular Sciences, University of Brighton, Brighton, United Kingdom
- Talgat Nurgozhin, MD, PhD, Laboratory of Experimental and Clinical Pharmacology and Pharmacy, National Laboratory Astana, Nazarbayev University, Astana, Kazakhstan
- Sergey Mikhalovsky, PhD, School of Biomaterials and Biomolecular Sciences, University of Brighton, Brighton, United Kingdom; and School of Engineering, Nazarbayev University, Astana, Kazakhstan
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Low WL, Kenward K, Britland ST, Amin MC, Martin C. Essential oils and metal ions as alternative antimicrobial agents: a focus on tea tree oil and silver. Int Wound J 2016; 14:369-384. [PMID: 27146784 DOI: 10.1111/iwj.12611] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Revised: 04/04/2016] [Accepted: 04/06/2016] [Indexed: 01/22/2023] Open
Abstract
The increasing occurrence of hospital-acquired infections and the emerging problems posed by antibiotic-resistant microbial strains have both contributed to the escalating cost of treatment. The presence of infection at the wound site can potentially stall the healing process at the inflammatory stage, leading to the development of a chronic wound. Traditional wound treatment regimes can no longer cope with the complications posed by antibiotic-resistant strains; hence, there is a need to explore the use of alternative antimicrobial agents. Pre-antibiotic compounds, including heavy metal ions and essential oils, have been re-investigated for their potential use as effective antimicrobial agents. Essential oils have potent antimicrobial, antifungal, antiviral, anti-inflammatory, antioxidant and other beneficial therapeutic properties. Similarly, heavy metal ions have also been used as disinfecting agents because of their broad spectrum activities. Both of these alternative antimicrobials interact with many different intracellular components, thereby resulting in the disruption of vital cell functions and eventually cell death. This review will discuss the application of essential oils and heavy metal ions, particularly tea tree oil and silver ions, as alternative antimicrobial agents for the treatment of chronic, infected wounds.
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Affiliation(s)
- Wan-Li Low
- School of Pharmacy, University of Wolverhampton, Wolverhampton, UK
| | - Ken Kenward
- School of Pharmacy, University of Wolverhampton, Wolverhampton, UK
| | - Stephen T Britland
- School of Pharmacy, University of Wolverhampton, Wolverhampton, UK.,Research Institute in Healthcare Science, Faculty of Science and Engineering, University of Wolverhampton, Wolverhampton, UK
| | - Mohd Cim Amin
- Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Claire Martin
- School of Pharmacy, University of Wolverhampton, Wolverhampton, UK.,Research Institute in Healthcare Science, Faculty of Science and Engineering, University of Wolverhampton, Wolverhampton, UK
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da Costa Santos CM, de Mattos Pimenta CA, Nobre MRC. A systematic review of topical treatments to control the odor of malignant fungating wounds. J Pain Symptom Manage 2010; 39:1065-76. [PMID: 20538188 DOI: 10.1016/j.jpainsymman.2009.11.319] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2008] [Revised: 10/26/2009] [Accepted: 11/10/2009] [Indexed: 11/29/2022]
Abstract
CONTEXT Malignant fungating wounds (MFW) result from cutaneous infiltration by carcinogenic cells. Fetid odor, profuse exudate, pain, and infection are common symptoms that add to the physical and psychological suffering of patients with MFW. The topical treatment of MFW remains controversial. OBJECTIVES To collect evidence about topical treatments to control the odor of MFW. METHODS Fourteen sources of data were used, without restriction in terms of language, period, or study design. The patient, intervention, comparison, and outcome strategy for the development of research questions yielded 334 descriptors related to oncology, MFW, topical treatments, medications, and symptoms of these lesions. Data from the abstracts of these articles were extracted by two independent researchers and decisions were reached by consensus among them. Through an analysis of these abstracts, studies that broached the topic of MFW odor were selected. These studies were analyzed in their entirety and were classified according to quality, levels of evidence, and grade of recommendation. RESULTS Of 11,111 studies identified, 325 (2.93%) made reference to the control of some symptoms of MFW by means of topical interventions: 12.4% related to odor, 16.8% to exudate, 17.8% to bleeding, 31.0% to pain, and 22.0% to MFW-related infection. Within the 59 studies that analyzed odor control, seven were clinical trials (35%), five were case series (25%), and eight (40%) were case studies. Eleven topical treatments were identified. Topical metronidazole and Mesalt dressing yielded 2b level of evidence or B grade of recommendation. Activated carbon dressing and curcumin ointment yielded 2c level of evidence or B grade of recommendation. C and D grades of recommendation were observed for seven topical treatments: topical arsenic trioxide, essential oils, green tea extract, hydropolymer dressings, antiseptic solutions, hydrogels, and debridement enzymes. The variety of interventions and of the methodological quality of the studies did not allow for meta-analysis. CONCLUSION Of the 59 studies of odor, 20 fulfilled all the criteria for inclusion. Few studies of high quality were found, and the principal methodological flaws were the design of the studies, the sample size, and the absence of scales to measure odor. Grade B evidence for the treatment of MFW was found with topical metronidazole, Mesalt dressing, activated carbon dressing, and curcumin ointment.
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Kurade NP, Jaitak V, Kaul VK, Sharma OP. Chemical composition and antibacterial activity of essential oils of Lantana camara, Ageratum houstonianum and Eupatorium adenophorum. PHARMACEUTICAL BIOLOGY 2010; 48:539-544. [PMID: 20645797 DOI: 10.3109/13880200903193336] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Essential oils have applications in folk medicine, food preservation, and as feed additives. The essential oils of Lantana camara Linn. (Verbenaceae), Ageratum houstonianum Mill. (Asteraceae) and Eupatorium adenophorum Spreng. (Asteraceae) were analyzed by Gas chromatography-mass spectrometry (GCMS). In L. camara oil, of the total identified (83.91%) volatile constituents, five constituents [3,7,11-trimethyl-1,6,10-dodecatriene (28.86%), beta-caryophyllene (12.28%), zingiberene (7.63%), gamma-curcumene (7.50%) and alpha-humulene (3.99%)] represented the major ones. In A. houstonianum oil, among the total identified volatile constituents (94.51%), three [precocene-II (52.64%), precocene-I (22.45%) and beta-caryophyllene (9.66%)] represented the major ones. In E. adenophorum oil, of the total identified volatile constituents (84.95%), six [1-napthalenol (17.50%), alpha-bisabolol (9.53%), bornyl acetate (8.98%), beta-bisabolene (6.16%), germacrene-D (5.74%) and alpha- phellandrene (3.85%)] represented the major ones. The antibacterial activity expressed as Minimum Bactericidal Concentration (MBC) (microg/mL) was determined by the broth dilution method. The essential oil of E. adenophorum had antibacterial activity against Arthrobacter protophormiae, Escherichia coli, Micrococcus luteus, Rhodococcus rhodochrous, and Staphylococcus aureus with MBC values of 200, 100, 100, 12.5, and 200, respectively. The essential oil of A. houstonianum showed antibacterial activity against M. luteus and R. rhodochrous with MBC of 100 and 12.5, but not against A. protophormiae, E. coli, and S. aureus. The essential oil of L. camara showed antibacterial activity against A. protophormiae, M. luteus, R. rhodochrous and S. aureus with MBC of 50, 25, 12.5, and 200, respectively, but not against E. coli. MBC was lowest for R. rhodochrous for all the three essential oils.
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Affiliation(s)
- Nitin P Kurade
- Indian Veterinary Research Institute, Regional Station, Palampur, Himachal Pradesh, India
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