Management of odor in fungating wounds comparing metronidazole polihexanide: randomized clinical trial

• Grant number: 13/01179-4
• Support Opportunities: Regular Research Grants
• Start date: May 01, 2013
• End date: April 30, 2015
• Field of knowledge: Health Sciences - Nursing - Medical-Surgical Nursing
• Principal Investigator: Vera Lúcia Conceição de Gouveia Santos
• Grantee: Vera Lúcia Conceição de Gouveia Santos
• Host Institution: Escola de Enfermagem (EE). Universidade de São Paulo (USP). São Paulo , SP, Brazil

Abstract

The fungating wounds(FW) has an incidence of 5% in patients in palliative care for cancer. The indicated therapy for these wounds is the management of symptom, where odor is a symptom with more impact for the patient and family. For odor control, the literature recommends a solution of 0.8% metronidazole (do not describing how manipulate), but there is no topical metronidazole solution available in Brazil. Nursing steeps metronidazole tablets and diluted in saline solution at bedside, but this practice is not proper handling of medications seen to be the responsibility of the pharmacist and be oral tablet (being used off label). Thus, we propose a randomized double-blind study to test an antiseptic (Polihexanide-PHMB) for topical use in wounds, compared with the 0.8% metronidazole solution. It is believed that the PHMB is also effective in controlling odor, and if this hypothesis will be confirmed, we will have a therapeutic option available for use and access to all. Thus, we propose a randomized double-blind study to test an antiseptic (Polihexanide-PHMB) for topical use in wounds, compared with the 0.8% metronidazole solution. 64 subjects will be recruited with FW with odor and randomized into 2 groups, control group and experimental group with metronidazole versus PHMB in two oncological institutions of São Paulo (both institutions applied metronidazole solution as protocol in controlling odor FW). The subject will be followed for up to 12 days and were evaluated on days zero, 4, 8 and 12. Is applied 4 rating scales by 3 professionals, three scales relating to odor and a related aspect of the wound; and three scales applied to the subject being, two related to soreness in exchange for dressings and on quality life. Data analysis will be by Friedman test, Fisher exact test. (AU)