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Oral Abstracts (Session 2 of 5)
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Moderator: John M. MacDonald, MD, FACS (Presentation 33.4) Effectiveness of a topical formulation containing metronidazole for wound odor and exudate control Cathy Kalinski, RN, BSN, CWCN, COCN; Mary Schnepf, RNC, MPH, ET; Lucy Hernandez, MS, APRN, BC; Jeanne Nusbaum, RN; Brian McGrinder, RPh; Debra A. Laboy, RPh; Ray Gizienski, RPh; Christopher Comfort, MD; Oscar M. Alvarez, PhD, Calvary Hospital, Bronx, NY Abstract: In chronic wound patients with advanced disease, endpoints other than closure offer improvements in quality of life. Odor management and exudate control are realistic wound care goals that have not received a great deal of attention. Sixteen cancer patients with malodorous wounds were treated with a compounded topical formulation consisting of metronidazole 0.75% w:w in a gel vehicle. Treatments were performed QD or BID at dressing changes consisting of a nonadherent primary dressing and an absorbent (gauze or non-woven) secondary dressing. Wound odor was evaluated both by the patient and caregiver using a subjective assessment scale of 0–10 (0=no odor detectable, 5=moderate, noticeable but not offensive, 10=offensive, putrid). Wound exudate and periwound skin maceration were evaluated clinically. Safety evaluations included wound volume (to see if the test agent deteriorated the wound) and monitoring of unexpected adverse events. Complete elimination of odor (rating of 0) was reported in 10 patients (62.5%) 24 hours after the initial application. There was significant odor control (>3 units in the odor scale) in the remaining 6 patients (37.5%). Of the 6 patients that noticed odor control (improvement without elimination), 5 (83.3%) had wounds in the perineal and rectal areas. In this limited survey, topically applied metronidazole 0.75% gel did not cause wound deterioration or an adverse effect. Unlike the commercially available formulation (Metrogel®, Galderma Laboratories, LP, Fort Worth, Tex), this formulation (compounded in our pharmacy) does not contain the preservatives methylparaben or editate disodium. Topical metronidazole 0.75% appears effective in controlling wound odor. |
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