Clinical Epidemiology and Ageing

Volatile Organic Compounds of Malignant Breast Cancer Wounds: Identification and Odors.

Thuleau A, Dugay J, Dacremont C, Jemmali Z, Elard J, De Ricke Y, Cassoux N, Watson S, Escande M-C, Fromantin I Wounds. 2018;30(11):337–344.

<p><b>INTRODUCTION: </b>During the metabolic processes of malignant wounds, bacteria produce a large amount of volatile organic compounds (VOCs) that are responsible for malodors and may have a major impact on the patient's quality of life with a risk of isolation.</p><p><b>OBJECTIVE: </b>A translational study was conducted on 32 malignant breast wounds by combining the identification of bacterial strains present on wounds, the identification of VOCs produced by these bacterial strains, and sensory evaluation to assess odor intensity and quality of odorous bacteria.</p><p><b>MATERIALS AND METHODS: </b>Thirty-two patients with malignant breast cancer wounds > 10 cm2 at various stages of the disease (curative or palliative) were included in the protocol. Volatile organic compounds were collected from primary dressings by headspace solid-phase microextraction and then analyzed by gas chromatography separation coupled with a mass spectrometer detector analysis. Microbiological samplings were taken and analyzed on agar plates. The odors of selected bacteria were assessed by a panel of staff members.</p><p><b>RESULTS: </b>Proteus mirabilis and Fusobacterium necrophorum seem to produce the strongest and most typical malignant wound odor. The VOCs were analyzed and dimethyl disulfide, dimethyl trisulfide, phenol, indole, and 3-methylbutanal were found to be produced by bacteria generating the most typical wound odor.</p><p><b>CONCLUSIONS: </b>This study suggests the bacteria present in wounds may be responsible for odors. In addition, these findings could pave the way to engineer new types of dressings and to develop an evaluation method to assess their efficiency both quantitatively and qualitatively as well as improve quality of palliative care and comfort for women with malignant wounds.</p>