Wound Odor Management: Charcoal Wound Dressings

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aerobic proteus bacteria in a wound

by Laurie Swezey RN, BSN, CWOCN, CWS, FACCWS

Activated charcoal has been used in various types of wound care dressings. Although activated charcoal in itself does not enhance wound healing, it can help to minimize the odors associated with wounds. This is important, as wound odor can be very distressing for the patient, and the patient's family and caregivers. Wound odor can impact the quality of life of individuals with strong, persistent wound odor to have feelings of embarrassment, depression and isolation.1

Causes of Wound Odor

Wound odor is caused by bacteria that is harbored in the necrotic tissue of the wound. This bacteria usually contains both aerobic and anaerobic bacteria. Wound odor generally comes from the anaerobic bacteria, which emits putrescine and cadverine, causing malodor. There are some aerobic bacteria that also result in wound odor, such as proteus and klebsiella.2

Thankfully, one can become almost immune to unpleasant odors when exposure is prolonged, though wound odor can cause some individuals to experience appetite loss, vomiting or gagging reactions to the odor. Sensory cells can actually become desensitized to unpleasant odors, which may be why individuals living in close contact with an individual having a malodorous wound may seem to hardly notice an offensive odor.2

How Activated Charcoal Minimizes Wound Odor

As mentioned, activated charcoal has been added to many dressing types to control odor. The charcoal layer of the wound dressing absorbs the bacteria and localized wound toxins, as well as other odor causing matter found in the wound bed.

Infected wounds can present with malodor, in addition to pain and wound exudate. Odor-causing bacteria flourish in wound exudate and devitalized tissue. Charcoal is often combined with an antimicrobial agent for wound odor management and to control bacterial levels in the wound.3 Actisorb®, combining activated charcoal with silver, is an example of a combination dressing designed to reduce wound odor by controlling bacteria.4

Activated charcoal in wound dressings can reduce odor, thus reducing potential patient distress and embarrassment. It is safe to use and may be combined with an antimicrobial to enhance odor control. If you have a patient with an infected wound that is malodorous, consider using a charcoal dressing to manage odor and ease your patient’s distress.

1. Naylor, W. (2002) Part 1: Symptom control in the management of fungating wounds. World Wide Wounds. Retrieved April 8, 2015 from http://www.worldwidewounds.com/2002/march/Naylor/Symptom-Control-Fungati...
2. O’Brien, C. (2012). Malignant wounds: Managing Odor. Canadian Family Physician, 58(3); pg. 272-274. http://www.cfp.ca/content/58/3/272.full
3. Graves, M. & Sun, V. (2013). Providing quality wound care at the end of life. Journal of Hospice and Palliative Nursing; 15(2):66-74. http://www.medscape.com/viewarticle/780776_5
4. International case series: Using ACTISORB®: Case Studies. London: Wounds International, 2012. http://www.woundsinternational.com/media/issues/620/files/content_10586.pdf

About The Author
Laurie Swezey RN, BSN, CWOCN, CWS, FACCWS is a Certified Wound Therapist and enterostomal therapist, founder and president of WoundEducators.com, and advocate of incorporating digital and computer technology into the field of wound care.

The views and opinions expressed in this blog are solely those of the author, and do not represent the views of WoundSource, Kestrel Health Information, Inc., its affiliates, or subsidiary companies.


I appreciate the succinct explanation of wound odor's primary cause and the most common management choice. Odor is an often neglected, but very important, quality of life issue for both patients and their families. When the causes of the odor cannot be fully addressed, significant relief can often be provided by natural deodorants such as activated charcoal, cyclodextrins, and glycerin, which absorb odor-producing molecules. Although bacteria are the most common source of wound odor, they are not the only cause.
I will be presenting a poster at SAWC and WOCN discussing a less common cause of wound odor: exposed muscle tissue in a hospice patient with a large sarcoma. The dressings needed to be changed twice a day to accommodate the rapidly increasing size of the tumor. Because the family used continuously cleansing polymeric membrane dressings, the exposed tissue did not develop any signs of infection. However, it did have a "butcher shop" scent which was quite noticeable at dressing changes. Polymeric membrane dressings contain glycerin, which was able to contain this odor. The family reported that visitors coming to say goodbye to the patient were completely unaware of his tumor. Although they were advised that charcoal dressings could be used to decrease odor, they never felt a need for them because the polymeric membrane dressings provided complete odor control.
Linda Benskin, PhD, RN, SRN (Ghana), CWCN, CWS, DAPWCA
Clinical Research & Education Liaison, and Charity Liaison
Independent Nurse Researcher and Ferris Mfg. Corp.

Fleck, CA. Palliative dilemmas: wound odor. Wound Care Canada Fall 2006:(4)3:10-13,54. http://bluetoad.com/publication/index.php?i=105560. Accessed February 8, 2016.

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