Villela-Castro DL, Santos VLCG, Woo K, et al.
Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy an.... Date of publication 2018 Sep 1;volume 45(5):413-418.
1. J Wound Ostomy Continence Nurs. 2018 Sep/Oct;45(5):413-418. doi:
10.1097/WON.0000000000000460.
Polyhexanide Versus Metronidazole for Odor Management in Malignant (Fungating)
Wounds: A Double-Blinded, Randomized, Clinical Trial.
Villela-Castro DL(1), Santos VLCG, Woo K.
Author information:
(1)Diana Lima Villela-Castro, PhD, RN, Nursing Department, Continuing Education,
AC Camargo Cancer Center, Sao Paulo, SP, Brazil. Vera Lucia Conceição de Gouveia
Santos, PhD, RN, Medical Surgical Department, Nursing School of the University of
São Paulo, Sao Paulo, SP, Brazil; and Member of WCET Education Committee, Sao
Paulo, SP, Brazil. Kevin Woo, PhD, RN, FAPWCA, School of Nursing of the Queen's
University, Kingston, Ontario, Canada.
PURPOSE: The aim of this study was to compare the effects of 0.2%
polyhexamethylene biguanide (PHMB) to 0.8% metronidazole on malignant wound (MW)
odor, health-related quality of life (HRQOL), and pain upon application.
DESIGN: A double-blinded, randomized, clinical trial.
SUBJECTS AND SETTING: Twenty-four patients with malodorous MWs hospitalized in a
referral cancer center in Sao Paulo, Brazil, participated in the trial.
METHODS: Participants were randomly allocated to treatment with 0.8%
metronidazole solution (control group) or 0.2% PHMB (experimental group). Study
outcomes were measured at baseline (day 0), 4 days, and 8 days. The primary end
point was the odor that was measured in terms of its intensity, quality, and
impact on participants during the study period. Health-related quality of life
was measured with the Ferrans and Powers Quality of Life Index-Wounds Version
(FPQLI-WV) on day 0 and on the day when odor was completely eliminated as per
evaluation by the investigators. Pain intensity related to application of the
control and experimental solutions was measured as a secondary outcome using a
scale of 0 to 10.
RESULTS: Twenty patients (83.3%) were classified as having "no wound odor" at 4
days, and 100% achieved no wound odor by day 8 (P < .001). Odor control in
patients with MW significantly influenced their general HRQOL (P = .002). We
found no difference in odor elimination, or HRQOL, when patients managed with
PHMB were compared to those managed with metronidazole. There were no
statistically significant differences over time in pain measurement between the 2
groups.
CONCLUSIONS: Both PHMB and metronidazole significantly reduced odor in malodorous
MWs within 4 days. Neither solution was found to be more effective than the other
in the magnitude of odor reduction or its effect on condition-specific HRQOL.
DOI: 10.1097/WON.0000000000000460
PMID: 30086103
