NTRODUCTION: Pain at dressing change is the result of several factors including trauma and skin stripping caused by the repeated removal of adhesive dressings. GOALS: To evaluate pain during dressing changes comparing a soft silicone foam dressing (Mepilex Border; Mölnlycke Health Care AB, Gothenburg, Sweden) with an adhesive hydrocellular polyurethane foam dressing (Allevyn Adhesive; Smith & Nephew, Hull, United Kingdom). METHODS: In this randomized crossover study, subjects were randomized to 1 of the 2 foam dressings for the first 2 scheduled follow-up visits. At visit 3, local wound treatment was switched to the alternate dressing until the end of the study (visits 4 and 5). Pain was measured with a visual analog scale and the Short-Form McGill Pain Questionnaire. The characteristics of the wound and the occurrence of adverse events were documented at each scheduled visit. RESULTS: A total of 32 patients entered into the study, and 26 patients completed all 5 follow-up study visits. Results indicated lower levels of pain at dressing removal and less periwound maceration in patients who were randomized to the silicone dressings. CONCLUSIONS: The results of this study indicate that soft silicone dressing is associated with less pain before and during dressing changes along with decreased periwound maceration.