By the WoundSource Editors
Chronic wounds pose an ongoing challenge for clinicians, and there needs to be a clearer understanding of the pathophysiology of wound chronicity and treatment modalities available.
By Laurie Swezey RN, BSN, CWOCN, CWS, FACCWS
Dressing changes can be painful experiences for clients. Pain is often not addressed or may be addressed inadequately. Pain is a significant issue for many clients and can present a challenge to the treating practitioner.
Types of Pain
There are four types of pain highlighted in the World Union of Wound Healing Societies' consensus document (2004):
When and How Should Pain be Assessed?
Pain should be assessed at the first visit with a client requiring ongoing dressing changes. The nature (i.e., procedural or incident pain), the location and the intensity of the pain should be documented. Thereafter, pain should be assessed before, during and after a dressing change has been performed in order to determine whether the pain has changed (improved or worsened) and whether the pain relief modalities are still effective in reducing the client’s level of pain.
Use of Pain Assessment Tools
Pain assessment tools are useful because they draw attention to the client’s pain, which may otherwise not be addressed, allow clinicians to recognize changes in pain levels over time, even when different clinicians are seeing the client, and provide a way to clearly measure (quantify) the client’s pain.
Verbal, visual analogue and numerical rating scales are all acceptable tools to measure pain. What is most important is continuity- the same scale should be used for every visit. Together, the client and clinician should decide on an acceptable level of pain for the client. If pain increases, the clinician should make every effort to determine the reason, such as infection, and work to reduce the client’s level of pain to the agreed-upon acceptable level of pain.
Managing Wound Pain During Dressing Changes
Strategies to reduce the client’s level of pain during dressing changes may include:
These are just a few of the strategies that can be used to reduce pain during dressing changes. Remember that pain is highly individual; what works for one client may not work well for another. Allowing the client to participate as much as they are able in decision-making can reduce apprehension and pain during the dressing change process.
Reducing Pain During Wound Dressing Changes. Wound Essentials. Volume 3, 2008. Available at: http://www.wounds-uk.com/pdf/content_9433.pdf.
World Union of Wound Healing Societies (2004). Principles of Best Practice: Minimising Pain at Wound Dressing–Related Procedures. A Consensus Document. Available at: http://www.wuwhs.org/pdf/consensus_eng.pdf.
Sardina, D. (2012). Ouch! That hurts! Wound Care Advisor, October 9, 2012. Available at: http://woundcareadvisor.com/best-practices-vol1-no3/.
About The Author
Laurie Swezey RN, BSN, CWOCN, CWS, FACCWS is a Certified Wound Therapist and enterostomal therapist, founder and president of WoundEducators.com, and advocate of incorporating digital and computer technology into the field of wound care.
The views and opinions expressed in this blog are solely those of the author, and do not represent the views of WoundSource, Kestrel Health Information, Inc., its affiliates, or subsidiary companies.