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    Wound vac foul odor

    My husband has had a wound vac since February for an ischeal pressure sore. It certainly has been a godsend. There is just one problem. Even though there is no leak at the wound site or vac, there is almost constantly a foul odor coming from the wound. One of his aides thought maybe it was the black foam that is used when changing the dressing. There is no longer the white foam inside that was being used for a long time. Has anyone ever heard of this and if so what is it and what is the solution??? This is to the point where my husband- who cannot smell very well - is so nauseated by the odor he is barely eating. Thanks for any thoughts.
    Last edited by Nickib; 11 Oct 2021, 10:15 PM.

    #2
    I'd be concerned about an infection with a foul smell. Is he seeing a wound doc or clinic? My concern would be if sepsis set in. It can do major damage in a matter of hours to the point of killing the person.I had a ps for quite a while and tried and tried to get it to heal. Finally tried the wound clinic who finally brought in a plastic surgeon to check it out. He said he could do a simple flap and would need to do complete bedrest on a Clintron bed in an assisted living residence for six weeks. I was at the point where I was so tired of the the regimen of trying to heal it, it was time to accept getting a flap.

    Was a two week wait while my insurance okayed the surgery; in between I contracted sepsis and was rushed to the ER. Doc said if I had waited until the morning it would have been too late. It turned from a simple flap surgery to major surgery to excise the sepsis infection tunneling to my nearest artery, a long wait to get rid of the infection and then a more major flap surgery needed because of the sepsis infection damage. Once everything healed up, I got my life back and haven't had a skin issue for 6 years.

    For myself, I'd be checking with who ever is in charge of the wound about the smell and if the wound is not healing like it should, it's time to think about getting a flap and get back to living life.

    Comment


      #3
      If he is already been treated for any osteomyelitis it is unlikely to be an infection, but he should have a white blood count, sed rate, and CRP blood test done to be sure. As above, you should talk to the physician who prescribed the wound V.A.C. as well as the home health nurse in charge of supervising it's use/changing the dressings.

      How often are you changing the dressing? Has silver sponge been suggested (it is anti-bacterial)? I assume this is brand name V.A.C. not some other negative pressure wound therapy (NPWT), as most of them don't have silver sponge. There are also canisters that have an gel power that helps control odor as an option vs. the regular canisters for the V.A.C.

      (KLD)
      The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

      Comment


        #4
        Originally posted by SCI-Nurse View Post
        If he is already been treated for any osteomyelitis it is unlikely to be an infection, but he should have a white blood count, sed rate, and CRP blood test done to be sure. As above, you should talk to the physician who prescribed the wound V.A.C. as well as the home health nurse in charge of supervising it's use/changing the dressings.

        How often are you changing the dressing? Has silver sponge been suggested (it is anti-bacterial)? I assume this is brand name V.A.C. not some other negative pressure wound therapy (NPWT), as most of them don't have silver sponge. There are also canisters that have an gel power that helps control odor as an option vs. the regular canisters for the V.A.C.

        (KLD)
        He sees his plastic surgeon frequently and has an appointment this Thursday. It’s a KCI which I’m assuming based on we’ve been told it’s $7000 to replace if we “lose” it that is a name brand. The canister does have a white gel pack and I have a supersonic nose. I’ve smelled everywhere and it’s definitely from the wound. Nurse comes every other day. Oddly enough we were on a week break and I wet-to-dry packed it once, sometimes twice a day after washing with vashe, no odor and nurse said it looked great and was actually smaller! When he was inpatient for this in February you could literally fit a small child’s fist in it that’s how deep it was - to the bone. I’m not sure what “silver” sponge is I just know until about 6-8 weeks ago they packed with a white sponge then always have finished with a black sponge. The packaging says it’s “VAC granufoam dressing”. Thank you for any further suggestions.

        Comment


          #5
          KCI makes a silver impregnated black sponge (more expensive of course) which we used for grossly infected wounds. The white sponge actually is designed for small spaces, and does not work as well as the black or silver sponge in stimulating granulation tissue.

          Was he treated for osteomyelitis (usually 6-8 weeks of IV antibiotics)? 90% of stage IV (to the bone) pressure injuries have osteomyelitis, and it is VERY difficult to eradicate. Ask the plastic surgeon about getting the blood work done that I suggested above. If that indicates active infection, he may need another MRI and/or bone biopsy to make a solid diagnosis of osteomyelitis.

          KCI clearly states that the V.A.C. should only be used if any osteomyelitis has been treated.

          (KLD)
          The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

          Comment


            #6
            Yes to all of your questions. He was treated with IV antibiotics through an infectious disease specialist. At one point the plastic surgeon was going to do a bone biopsy but the wound healed so well and quickly after the wound vac was started in February that he decided it was not necessary. I have forwarded your information and suggestions to him to present on Thursday. Thank you so much! I’ll report back after his appointment!

            Comment


              #7
              I would just add that wet to dry dressings should only be used for debridement of dead tissue. Wet to moist is appropriate for a clean, granulating wound. Otherwise, when you pull out the dry dressing, you may also be ripping out healing granulation tissue, which needs a constant moist environment.

              (KLD)
              The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

              Comment


                #8
                So dumb question….remember I’m not a nurse…when I was doing the wet to dry for a week (cleaning with vashe first) by the time I changed the dressing everything was soaked to the point no more moisture could be wicked away. I was afraid of the possibility of damaging healthy tissue but from what the nurse said everything was ok. Honestly I don’t know whether to believe what they tell me or not.

                Comment


                • SCI-Nurse
                  SCI-Nurse commented
                  Editing a comment
                  Just be sure to change the dressing before it gets dry. This usually means 3X daily dressing changes. What solution were you using on the dressing itself? (KLD)

                #9
                Nothing. The dressing never gets dry - in fact sometimes it leaks through unless the vac is on. The nurses use saline. For the week that he didn’t use the vac the dressing package said it would be good for 7 days! Not true! He just sent me a message the odor is so bad today - the vac was just changed yesterday by the nurse.

                Comment


                  #10
                  Any smell is not good. I have a low tolerance for smell 👃 and the last time I smelled something the wounds were in need of debridement. The nurse didn't catch it as he was overwhelmed with new clients.

                  Sometimes I also smell the VAC wound coverage smelling like old blood leaking. When that happens we have to locate leaking wound vac coverage.

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