Sources of the foul odor:
(1) tissue decomposition
(2) bacteria, especially anaerobic bacteria
(3) a fistula or other communication with the colon
The ideal solution is to get the wound to heal.
If the wound cannot heal then the odor can be controlled by:
(1) Masking it with a more pleasant odor.
(2) Covering the wound with an activated charcoal dressing that absorbs the odor.
(3) Debriding the tissue to remove necrotic tissue. This could include the use of maggots.
(4) Identifying the bacteria in the wound that are causing odor, then select a topical antibiotic treatment that suppresses its growth, such as metronidazole gel.
(5) Use a dressing that reduces moisture in the wound.
(6) If the wound is associated with a fistula or communication with the colon, then consider surgery to close the fistula or relocate an ostomy site.
Hyperbaric oxygen therapy may be worth considering if all else fails.
