Dissemin is shutting down on January 1st, 2025

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Wiley Open Access, International Wound Journal, 2(5), p. 159-171, 2008

DOI: 10.1111/j.1742-481x.2008.00471.x

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Dressing-related pain in patients with chronic wounds: an international patient perspective

This paper is made freely available by the publisher.
This paper is made freely available by the publisher.

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Data provided by SHERPA/RoMEO

Abstract

This cross-sectional international survey assessed patients’ perceptions of their wound pain. A total of 2018 patients (57% female) from 15 different countries with a mean age of 68.6 years (SD ¼ 15.4) participated. The wounds were categorised into ten different types with a mean wound duration of 19.6 months (SD ¼ 51.8). For 2018 patients, 3361 dressings/compression systems were being used, with antimicrobials being reported most frequently (n ¼ 605). Frequency of wound-related pain was reported as 32.2%, ‘never’ or ‘rarely’, 31.1%, ‘quite often’ and 36.6%, ‘most’ or ‘all of the time’, with venous and arterial ulcers associated with more frequent pain (P ¼ 0.002). All patients reported that ‘the wound itself’ was the most painful location (n ¼ 1840). When asked if they experienced dressing-related pain, 286 (14.7%) replied ‘most of the time’ and 334 (17.2%) reported pain ‘all of the time’; venous, mixed and arterial ulcers were associated with more frequent pain at dressing change (P , 0.001). Eight hundred and twelve (40.2%) patients reported that it took ,1 hour for the pain to subside after a dressing change, for 449 (22.2%) it took 1–2 hours, for 192 (9.5%) it took 3–5 hours and for 154 (7.6%) patients it took more than 5 hours. Pain intensity was measured using a visual analogue scale (VAS) (0–100) giving a mean score of 44.5 (SD ¼ 30.5, n ¼ 1981). Of the 1141 who reported that they generally took pain relief,21% indicated that they did not feel it was effective. Patients were asked to rate six symptoms associated with living with a chronic wound; ‘pain’ was given the highest mean score of 3.1 (n ¼ 1898). In terms of different types of daily activities, ‘overdoing things’ was associated with the highest mean score (mean ¼ 2.6, n ¼ 1916). During the stages of the dressing change procedure; ‘touching/handling the wound’ was given the highest mean score of 2.9, followed by cleansing and dressing removal (n ¼ 1944). One thousand four hundred and eighty-five (80.15%) patients responded that they liked to be actively involved in their dressing changes, 1141 (58.15%) responded that they were concerned about the long-term side-effects of medication, 790 (40.3%) of patient indicated that the pain at dressing change was the worst part of living with a wound. This study adds substantially to our knowledge of how patients experience wound pain and gives us the opportunity to explore cultural differences in more detail.