AIMS AND OBJECTIVES: To describe the current scientific evidence in the field of diagnostics and treatment of pain, malodour and exudate from pressure ulcers.

DESIGN: Systematic literature review.

METHODS: Medline, Cinahl, and Cochrane, were searched for studies on pain, malodour and exudate in patients with pressure ulcers. In addition, a search in specific journals was made by hand.

RESULTS: The McGill Pain Questionnaire, the Visual Analogue Scale and the Faces Rating Scale are useful instruments to assess pressure ulcer related pain. Some evidence was found to support a positive effect of benzydamine gel and Eutectic Mixture of Local Anaesthetic-cream. Wound malodour is subjectively assessed. In a laboratory study it is proved that activated charcoal is capable to absorb gas molecules causing malodour. At present, no studies are available on the odour-absorbing capacity of activated charcoal dressings in pressure ulcer patients. Exudate is a symptom of impaired wound healing. The Pressure Sore Status Tool is a valid and reliable instrument for assessing the wound healing process. There is a possible indication that hydrocolloid positively influences healing time because the absorption of exudates is more effective.

CONCLUSION: Very little sound research has been performed on wound-related complaints in patients with pressure ulcers. Nevertheless several recommendations could be made on the present state of the art.