Pain in Chronic Wounds

NewsBot · Jul 14, 2018

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Assessment of pain in chronic wounds: A survey of Australian health care practitioners.
Frescos N
Int Wound J. 2018 Jul 12.

Pain associated with chronic wounds can delay wound healing, affects quality of life, and has a major impact on physical, emotional, and cognitive function. However, wound-related pain is often under-assessed and may therefore be suboptimally managed. The aim of this study was to describe the assessment practices used to assess chronic wound pain by health practitioners in Australia. A structured self-administered questionnaire was posted to members of an Australian national wound care organisation, whose membership represents various health practitioners involved in wound management. A total of 1190 (53%) members completed the survey. Overall, wound pain assessment was most commonly conducted at every consultation or wound dressing change (n = 718/1173, 61%). Nurses were more likely to assess wound-related pain before, during, and after the wound dressing procedures compared with other health care practitioners. In contrast, podiatrists assessed wound pain only when the patient complained about the pain. The most common assessment method was simply talking to the patient (n = 1005/1180, 85%). Two-thirds of practitioners used a validated pain assessment tool. The most commonly used tool was the numerical analogue scale (n = 524/1175, 46%). In summary, these findings suggest that there is no consistent method for the assessment of wound-related pain, and there are substantial variations in how and when wound-related pain is assessed between different professions.
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NewsBot · Oct 25, 2019

Assessment and management of pain during dressing change in patients with diabetic foot ulcers: a best practice implementation project.
Ren Y et al
JBI Database System Rev Implement Rep. 2019 Aug 28

INTRODUCTION:
Pain caused by dressing change has adverse effects on patients with a diabetic foot ulcer, including sleep disturbances, immobility, depression and anxiety. It is crucial that healthcare professionals use a standardized tool to assess and document pain during dressing change and then use this information to inform strategies to alleviate the pain.

OBJECTIVES:
The aim of this project was to implement evidence-based practice in assessment and management of pain during dressing change among patients with diabetic foot ulcers in an endocrinology unit in a tertiary hospital.

METHODS:
The JBI Practical Application of Clinical Evidence System (JBI PACES) and Getting Research into Practice (GRiP) audit and feedback tool were used for auditing clinical practice and translating evidence into practice. A baseline audit was performed to assess compliance with six criteria, followed by the implementation of evidence-based interventions to improve compliance. The follow-up audit using the same audit criteria was conducted to assess the effect of targeted strategies on compliance with best practice.

RESULTS:
The baseline audit revealed that compliance with evidence-based practice was low, with only one of the six audit criteria achieving a compliance rate above 60%. After brainstorming and synthesizing the literature, the project team identified barriers and strategies for implementing best practice. The follow-up audit showed improvements in compliance across all six criteria, although there was only a small improvement in one of the criteria. The compliance rate of the other five criteria improved to greater than 67%.

CONCLUSION:
A best practice implementation project that involved standardizing pain assessment and management, and delivering education materials to nursing staff and patients was completed using JBI PACES and GRiP. The project improved nurses' compliance with best practice. Nurses attach importance to relieving patients' pain when they accept wound care, while patients with a diabetic foot ulcer gain access to high-quality wound care. Future studies will be conducted to address new barriers that emerged during the follow-up audit.
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NewsBot · Jan 12, 2020

Pain in persons with chronic venous leg ulcers: A systematic review and meta‐analysis
Lena Leren Edda Johansen Hilde Eide Ragnhild S. Falk Lene K. Juvet Tone M. Ljoså
IWJ; 03 January 2020

Pain is a serious problem for patients with leg ulcers. Research mainly focuses on dressing‐related pain; however, chronic background pain may be just as devastating. Our main objective was to describe the prevalence and characteristics of wound‐related background pain in persons with chronic venous leg ulcers. We performed a systematic review to synthesise data from quantitative studies. Studies were eligible if they reported original baseline‐ or cross‐sectional data on background pain in chronic venous leg ulcers. The initial search identified 2454 publications. We included 36 descriptive and effect studies. The pooled prevalence of wound‐related background pain (from 10 studies) was 80% (95% CI 65‐92%). The mean pain intensity score (from 27 studies) was 4 (0‐10 numeric rating scale) (95% CI 3.4‐4.5). Other pain characteristics could not be synthesised. We identified few sufficiently high‐quality studies on prevalence and intensity of wound‐related background pain in patients with chronic venous leg ulcers. Four of five persons experience mild to moderate pain. Because of poor quality of pain assessment and report, we believe that the available research does not provide a sufficiently nuanced understanding of background pain in this patient group.
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NewsBot · Sep 20, 2023

Systematic review of topical interventions for the management of pain in chronic wounds
Cathal Ffrench et al
Pain Rep. 2023 Sep 12;8(5):e1073

Chronic wounds adversely affect quality of life. Pain is associated with chronic wounds, and its impact can vary according to wound aetiology, condition, and patient factors. This systematic review examined the effectiveness of topical interventions in the management chronic wound-related pain guided by PRISMA recommendations of randomised controlled trials (RCTs) where pain reduction is the primary outcome. Inclusion criteria were adults (older than 18 years) with chronic venous, arterial, diabetic, or pressure ulcers where pain has been managed through topical administration of pharmacological/nonpharmacological agents. Searches were conducted in Ovid Embase, Ovid MEDLINE, EBSCOhost, CINAHL, CENTRAL, PubMed, Web of Science, and Scopus. Studies were screened for eligibility; risk of bias and data were extracted by 2 independent assessors. Searches retrieved 10,327 titles and abstracts (7760 after deduplication). Nine full texts (1323 participants) examining ibuprofen (n = 4), morphine (n = 2), BWD + PHMB [polihexanide-containing biocellulose wound dressing] (n = 1), and EMLA (n = 2) were included. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool. Meta-analysis was not possible, but initial exploration suggests improved outcomes (reduced pain) for ibuprofen when compared with controls. Two studies involving morphine showed conflicting findings. Included studies often had small samples, and considering confounding factors (eg, comorbidities), the results should be interpreted with caution. Review of included studies suggests that topical interventions may provide pain relief in individuals with chronic wounds. Further adequately powered RCTs are recommended to assess the efficacy of topical interventions for the management of chronic wound-related pain.
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NewsBot · Feb 26, 2024

Effects of non-pharmacological interventions on pain in wound patients during dressing change: A systematic review
Yanfei Ma et al
Nurs Open. 2024 Feb;11(2):e2107

Background: Changes to the wound dressing frequently cause pain. Some adverse side effects of pharmacologic pain management may cause problems or even impede wound healing. There is no systematic study of non-pharmacologic therapies for pain during wound dressing changes, despite the gradual promotion of non-pharmacologic pain reduction methods.

Objectives: To give clinical wound pain management a new direction, locating and assessing non-pharmacological interventions regarding pain brought on by wound dressing changes are necessary.

Method: The researchers conducted a comprehensive literature review on non-pharmacological interventions for pain during wound dressing changes across five databases: PubMed, Web of Science, Medline, Embase, and the Cochrane Library spanning the period from January 2010 to September 2022. The evaluation of literature and data extraction was carried out independently by two researchers, and in cases of disagreement, a third researcher participated in the deliberation. To assess the risk of bias in the literature, the researchers utilised the Cochrane Handbook for Reviews of Interventions, version 5.1.0.

Results: In total, 951 people were involved in 11 investigations covering seven non-pharmacological therapies. For pain triggered by dressing changes, virtual reality (VR) distraction, auditory and visual distractions, foot reflexology, religious and spiritual care, and guided imaging demonstrated partially positive effects, with hypnosis therapy and jaw relaxation perhaps having a weak effect.

Conclusion: The key to managing wounds is pain management. According to our review, there is some indication that non-pharmacologic interventions can help patients feel less discomfort when having their wound dressings changed. However, the evidence supporting this view is weak. It needs to be corroborated by future research studies with multicentre and large samples. To promote and use various non-pharmacologic interventions in the future, it is also necessary to build standardised and homogenised paths for their implementation.
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Pain in Chronic Wounds

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Pain in Chronic Wounds

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

Patellofemoral Pain Syndrome Is Associated With Chronic Disease and Allergies

Chronic Pain Symptoms You Might Never Expect Are Coming from Your Feet

Tibial Nerve Block as Treatment of Chronic Foot Pain

Arthroscopic Surgery for the Treatment of Chronic Plantar Heel Pain

Chronic pain / inflammation in little toe outside edge of left foot

Chronic pain syndrome following hallux valgus surgery

Enhance Pain Self-efficacy in People With Chronic Musculoskeletal Pain

Share This Page

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