01 Nov 2010
When a group of Singapore General Hospital (SGH) nurses brainstormed for an effective alternative dressing for a type of cancer wound, they found the answer in green tea and the king of fruit, the strong-smelling durian.
Some cancer patients develop what is known as a fungating cancerous wound, so called because of its fungus or cauliflower shape, which occurs when the cancer grows out onto the skin. Patients with fungating cancerous wounds face many challenges in wound care, especially in controlling the unpleasant smell.
Hospitals use an antibiotic powder to control the odour, but it can become ineffective when patients develop resistance after prolonged use. Embarrassed by the smell from their wounds, they often withdraw from family and friends, and may even begin to eat alone at home.
“Cancer patients need a lot of support from friends and family, especially in the advanced stages. If the smell from their wounds is so intense, it can compound their misery due to the cancer, and deepen their sense of helplessness and social isolation,” said Ms Lian Siew Bee, Advanced Practice Nurse, Department of Medical Oncology, SGH. “We thought that if we could find a way to control the smell, we would be able to enhance the quality of life of patients and caregivers.”
Ms Lian and her nursing team experimented with charcoal tablets and even yogurt, but found both too messy to use on the wounds. During a regular discussion, they hit on the idea of using tea.
“One of the nurses recounted how she brought durians back from Bangkok without being detected,” said teammate Ms Aw Fung Chee. “She placed the durians in an airtight container and added a layer of teabags on top of it.”
Durians are not allowed on planes and public transport because of the overpowering smell – described as fragrant by fans of the fruit, and pungent by others. The tea, according to the story, was able to neutralise the smell of the durians.
Intrigued, Ms Lian led a team of nurses and an oncologist in a study to compare the effectiveness of green tea in controlling the odour from fungating cancerous wounds. For a week, 15 patients used the standard treatment – saline to wash the wound and an antibiotic powder, metronidazole, to control the odour.
Another 15 patients had their wounds cleaned using a green tea infusion and dry teabags in the outer dressing. The 30 patients were randomly allocated to either group.
The team found that green tea worked as well as the antibiotic powder, but with a few advantages.
Green tea doesn’t need a doctor’s prescription, and is easily available and cheap – a patient using advanced odour-controlling dressing materials for a very large wound may spend over $100 a day, compared with a box of 50 teabags, which costs about $6.
Some patients reported a cooling effect on their wounds cleaned with green tea.
Patients also do not develop resistance to tea, even after prolonged use, and to date, no side effect has been reported.
Ms Lian and her team presented their study at last year’s SGH Annual Scientific Meeting and won a Young Investigator’s Award (Nursing). The department now offers the green tea dressing as an alternative – an option few patients have turned down.
Mr Su Kin Seng is one of them. A 57- year-old who suffers from rectal cancer, Mr Su used the conventional antibiotic dressing for three years before switching to green tea two years ago.
“My wound doesn’t heal, and it has a lot of discharge. Using green tea reduces the smell significantly and (the smell) only comes back after eight hours, when it’s time to change the dressing,” Mr Su said.
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