Epidermolysis bullosa

Painful wounds are usually complicated chronic wounds, being pain a multifactorial symptom as was seen in chapter 5. The pain in the wound can be related to the infection or with a bad dressing selection, a bad dressing technique etc. Another important problem in wounds id itchiness, also covered already in more depth in chapter 6.

Intense smell is a relatively frequent and annoying symptom in EB wounds. Same as with pain, the smell usually worsens when there is an infection of the wounds. But other causes can be the impossibility to change the dressings and bandages as frequently as needed or the impossibility of using the most idoneal dressings for each wound. However, sometimes wounds can be smelly even when there is not an infection or when the changes of dressing and the corporal hygiene are strictly done; this can happen especially in areas with humid and hot climates, or in very small houses or without ventilation. Some of the measures to address it are:

• Consult when there is a significant change in the odour of the wounds to treat infections early.
• Change dressings and clean wounds in the shower or bath whenever possible. If this is not possible, it is recommended to clean by pouring water directly onto the wound (using a syringe) or by applying moist gauze pads. Pads are cloths or compresses soaked in an aqueous solution that are applied to the skin. Prolonged contact over time facilitates the penetration and, therefore, the action of this solution on the skin to be treated.
• Do not leave the dressings for more days than indicated by the nurse and change them sooner in cases where the exudate from the wound seeps through the bandages.
• Use some dressings with activated carbon whenever possible to protect the skin (since they are usually adhesive), always under the supervision of expert professionals. In some cases, the use of gels or liquids with anti-fungal products is recommended to treat superinfections by fungi; its indication must be medical.
• Since the smell can generate feelings of shame, guilt or sadness, it is advisable to be able to talk to people around us about this topic.
• Another recommendation that can be useful is to wear breathable clothing.