| Sumario: | Chronic wounds significantly impact health‐related quality of life (HRQoL). Unpleasant wound odour, caused by bacterial colonisation and necrotic processes, is a distressing symptom. Its exact composition is not well understood, but it could be the basis for a personalised odour avoidance strategy. Therefore, this feasibility study explored 92 wounds from 66 patients with the focus on wound odour, bacterial burden and their impact on health related‐quality of life (HRQoL). Volatile organic compounds (VOCs) responsible for wound odours were detected at the molecular level, using gas chromatography–mass spectrometry and ‐ion mobility spectrometry and correlated to the HRQoL. In patients analysed (average age 69 ± 13 years, wound persistence 24.31 ± 70.8 months) 135 pathogens were identified by swabbing including 19% Staphylococcus aureus, 15% Pseudomonas aeruginosa and 35% Enterobacteria. The specific questionnaire 'Wound‐QoL‐14' showed a non‐significant difference in HRQoL in patients with wound odour (2.1 ± 1.0 vs. 1.8 ± 1.0). The latter also had the highest number of VOC detections. The most frequently detected, relevant VOCs from prokaryotic sources were dimethyl‐disulphide and diacetyl‐(2,3‐butanedione). Furthermore, potential biomarkers for specific pathogens were identified, including dimethyl‐trisulphide for P. aeruginosa and indole for Escherichia coli. The most prevalent substance groups were ketones and alcohols. In conclusion, the malodour of chronic wounds is caused by a mixture of the intrinsic odour of bacterial products and necrosis. This exploratory study, which combines the analysis of decoded VOCs and the olfactory assessment of odour, could be a novel, targeted approach for identifying potential 'anti‐wound odour therapies' that will significantly benefit the HRQoL of patients with malodourous tumour wounds, in particular.
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