The smell of a fungating or ulcerating tumour can much distress patients and their relatives. Help can come from surgical toiletry and attentive nursing with fragrant dressings, activated charcoal, deodorisers and good ventilation,1 but even so smell often persists and demoralises the patient. The smell is often associated with anaerobic bacteria which colonise the moist necrotic tissue and produce volatile metabolites. Metronidazole 0.8% gel (Metrotop – Farmitalia CE) is promoted for ‘reducing the misery of fungating, smelly tumours’.
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