Effectiveness of metronidazole in the treatment of tumor wound odors
DOI:
https://doi.org/10.15253/2175-6783.2018193245Keywords:
Wounds and Injuries; Odorants; Metronidazole; Neoplasms.Abstract
Objective: to analyze the evidence of the effectiveness of Metronidazole in the treatment of odors in tumor wounds. Methods: this is an integrative review performed at the health databases and the PubMed portal. The studies were evaluated by the Jadad Scale (randomized clinical trials), Downs and Black (quasi-experiment) and the Strengthening the Reporting of Observational studies in Epidemiology (observational). A sample of the ten studies and articles were considered cut-off points that reached 50.0% of the criteria. Results: Metronidazole was effective in 95.6% of the cases and the gel preparation at 0.75% was the most used in the studies. Conclusion: the evidence indicates that metronidazole is safe and effective in the control of tumor wound odors, but there is no consensus on the most effective forms of presentation and administration routes. Most studies associate the appearance of bad odor with the growth of anaerobic bacteria in the tumor tissue.
References
Tilley C, Lipson J, Ramos M. palliative wound care for malignant fungating wounds: holistic considerations at end-of-life. Nurs Clin North Am. 2016; 51(3):513-31. doi: http://dx.doi.org/10.1016/j.cnur.2016.05.006
Tamai N, Mugita Y, Ikeda M, Sanada H. The relationship between malignant wound status and pain in breast cancer patients. Eur J Oncol Nurs. 2016; 24:8-12. doi: http://dx.doi.org/10.1016/j.ejon.2016.05.004
Probst S, Arber A, Faithfull S. Malignant fungating wounds – the meaning of living in an unbounded body. Eur J Oncol Nurs. 2013; 17(1):38-45. doi: http://dx.doi.org/10.1016/j.ejon.2012.02.001
Watanabe K, Shimo A, Tsugawa K, Tokuda Y, Yamauchi H, Miyai E, et al. Safe and effective deodorization of malodorous fungating tumors using topical metronidazole 0.75% gel (GK567): a multicenter, open-label, phase III study. Support Care Cancer. 2016; 24(6):2583-90. doi: http://dx.doi.org/10.1007/s00520-015-3067-0
Castro DLV, Santos VLCG. Controlling wound odor with metronidazole: a systematic review. Rev Esc Enferm USP. 2015; 49(5):858-63.doi:http://dx.doi.org/10.1590/S0080-623420150000500021
Romero-Collado A. Cuidados domiciliarios de enfermería a una mujer con una herida neoplásica en el ámbito de la atención primaria de la salud. Enferm Clín. 2012; 22(2):100-4. doi: http://dx.doi.org/10.1016/j.enfcli.2011.05.007
Galvão TF, Preira MG. Revisões sistemáticas da literatura: passos para sua elaboração. Epidemiol Serv Saúde. 2014; 23(1):183-4. doi: http://dx.doi.org/10.5123/S1679-49742014000100018
Galvão TF, Pansini TSA, Harrad D. Principais itens para relatar revisões sistemáticas e meta-análises: a recomendação PRISMA. Epidemiol Serv Saúde. 2015; 24(2):335-42. doi: http://dx.doi.org/10.5123/S1679-49742015000200017
Jadad AR, Moore RA, Carrol D, Jenkinson C, Reynolds DJM, Gavaghan DJ, et al. Assessing the quality of reports of randomized clinical trials: Is blinding necessary? Control Clin Trials. 1996; 17(1):1-12. doi: https://doi.org/10.1016/0197-2456(95)00134-4
Downs SH, Black N. The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions. J Epidemiol Community Health. 1998; 52:377-84. doi: http://dx.dg/oi.or10.1136/jech.52.6.377
Malta M, Cardoso LO, Bastos FI, Magnanini MMF, Silva CMFP. STROBE initiative: guidelines on reporting observational studies. Rev Saúde Pública. 2010; 44(3):559-65. doi: http://dx.doi.org/10.1590/S0034-89102010000300021
Agra G, Gouveia BLA, Sousa ATO, Costa MML, Oli-veira SHS, Soares MJG. Nursing palliative care in pa-tient with terebrating basal cell carcinoma: a case study. Rev Enferm UFPE on line [Internet]. 2015 [cited 2017 July 14]; 9(11):9873-81. Avaliable from: https://periodicos.ufpe.br/revistas/revis-taenfermagem/article/download/10781/11929
Agra G, Xavier VMA, Gouveia BLA, Andrade LL, Oliveira SHS, Costa ML. Nursing care to patient with breast fungating malignant wound: case study. Rev Enferm UFPE on line [Internet]. 2015 [cited 2017 July 14]; 9(6):8295-303. Avaliable from: http://www.revista.ufpe.br/revistaenfermagem/index.php/revista/article/view/7752/pdf_8028
Aiken K. Managing tissue necrosis associated with oral carcinoma. Clin J Oncol Nurs. 2004; 8(4):408-9. doi: https://doi.org/10.1188/04.CJON.408-409
Bauer C, Gerlach MA, Doughty D. Options in practice: care of metastatic skin lesions [editorial]. J Wound Ostomy Continence Nurs. 2000; 27(4):247-51. doi: https://doi.org/10.1067/mjw.2000.107985
Von Gruenigen VE, Coleman RL, Li AJ, Heard MC, Miller DS, Hemsell DL. Bacteriology and treatment of malodorous lower reproductive tract in gynecologic cancer patients. Obstet Gynecol [Internet]. 2000 [cited 2017 Oct 31]; 96(1):23-7. Available from: https://www.ncbi.nlm.nih.gov/pubmed/10862836
Kuge S, Tokuda Y, Ohta M, Okumura A, Kubota M, Ninomiya S, et al. Use of metronidazole gel to control malodor in advanced and recurrent breast cancer. Jpn J Clin Oncol [Internet]. 1996 [cited 2017 Oct 31]; 26(4):207-10. Available from: https://www.ncbi.nlm.nih.gov/pubmed/8765176
O’Brien C. Malignant wounds: managing odour. Can Fam Physician [Internet]. 2012 [cited 2017 Oct 31]; 58(3):272-4. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3303648/
West D. A palliative approach to the management of malodour from malignant fungating tumors. Int J Palliat Nurs. 2007; 13(3):137-42. doi: http://dx.doi.org/10.12968/ijpn.2007.13.3.23276
Finlay IG, Bowszyc J, Ramlau C, Gwiezdzinski Z. The effect of topical 0.75% metronidazole gel on malodorous cutaneous ulcers. J Pain Symptom Manage. 1996; 11(3):158-62. doi: https://doi.org/10.1016/0885-3924(95)00164-6