This study aimed to evaluate microbiological patterns and their relationship with outcomes in patients hospitalised for diabetic foot infection (DFI). It was a retrospective observational study involving 123 patients, with an average age of 67.8 years; 74.5% were male, and 97.5% had type 2 diabetes. Of these, 22% had osteomyelitis, while 78% had soft tissue infections. The most commonly isolated bacteria were Methicillin-susceptible Staphylococcus aureus (MSSA) (26%), Enterococcus faecalis (12.2%), Pseudomonas aeruginosa (10.6%), and Methicillin-resistant Staphylococcus aureus (MRSA) (7.3%). Polymicrobial infections were present in 37.8% of cases. Minor and major amputation rates were 56.3% and 4.2%, respectively. Amputees were older, had higher rates of ischemic diabetic foot ulcers (91.7% vs 70.6%), and higher white blood cell (WBC) levels (10.9 vs 8.3 x 10³/μL). However, no correlation was found between the type of bacteria, polymicrobial infections, or the type of infection and amputation. Severe infections, defined by WBC>12,000 x 10³/μL, were an independent predictor of amputation. Staphylococcus aureus was the most frequently isolated bacteria, but microbiological characteristics were not independently linked to amputation. Amputation was instead related to the clinical severity of the infection.

Background Wound-related odour has a negative impact on the quality of life of the patient and may be indicative of wound infection or deterioration. Wound assessment should incorporate odour assessment. This scoping review aimed to determine what wound odour assessment methods are incorporated into wound assessment tools.

Methods This review was guided by the Joanna Briggs Institute recommendations for the conduct of scoping reviews and reported according to the PRISMA-ScR checklist.

Results Five methods to assess wound odour used in wound assessment tools were identified: TELER; TSAW-W; WoSSAC; MWAT-C & R; and the National Wound Assessment Form. Each reported on the process of tool development with evidence of validity and reliability testing at the development stage. However, these tools were very poorly represented in research studies that aimed to evaluate the outcomes of interventions to manage odour.

Conclusions Validated methods of wound-related odour assessment do exist but are poorly represented in wound assessment tools or research studies. Numeric rating scales of odour intensity are the most frequently reported but do not take account of the level of interference or ‘bother’ for the patient or their families. We need a call to action for industry and the research community to recognise the significance of this problem and to work together to find solutions that are tested using validated tools.