Wound pain

Summary

In acute and chronic wounds, pain represents a common and central medical problem. Wound pain can be caused by multiple factors, such as macro- or microvascular as well as inflammatory processes.

The basic concept of pain management is based on the WHO pain ladder. Often this concept of pain therapy remains insufficient. Apart from the conventionally used anal-getics, there are not yet established guidelines for the use of alternative substances.Ultimately the adequate wound pain therapy must be adjusted to each patient and his comorbidities.

Keywords

Chronic wounds - wound pain - neuropathic pain - skin grafting - topical ketamine

• References

• 1 Carradice D. et al. Modelling the effect of venous disease on quality of life. Br J Surg 2011; 98: 1089-1098.
• 2 O’Donell TF. et al. Management of venous leg ulcers: Clinical practice guidelines of the Society for Vascular Surgery® and the American Venous Forum. J Vasc Surg 2014; 60: 3-S-59S.
• 3 Szor JK. et al. Description of pressure ulcer pain at rest and dressing change. J Wound Ostomy Continence Nurs 1999; 26: 115-120.
• 4 Meaume JS. et al. The importance of pain reduction through dressing selection in routine wound management: the MAPP study. J Wound Care 2004; 13: 409-413.
• 5 Husband LL. et al. Shaping the trasjectory of patients with venous ulceration in primary care. Health Expect 2001; 4: 189-198.
• 6 Pieper B.. et al. Pain associated with venous ulcers in injecting drug users. Ostomy Wound Manage 1998; 44 54-58. 60-67.
• 7 Nemeth KA. et al. Understanding venous leg ulcer pain: Results of a longitudinal study. Ostomy Wound Manage 2004; 50: 34-36.
• 8 Vasquez MA. et al. Revision of the venous clinical severity score: Venous outcomes consensus statement: Special communication of the American Venous Forum Ad Hoc Outcomes Working Group. J Vasc Surg 2011; 54 (06) 2S-9S.
• 9 Maessen-Visch MB. et al. Dutch Venous Ulcer guideline update. Phlebology 2014; 29: 153-156.
• 10 Vasquez MA. et al. Venous Clinical Severity Score and quality-of-life assessment tools: application to vein practice. Phlebology 2008; 23: 259-275.
• 11 Wulf H, Baron R. The theory of pain: Pain at wound dressing changes.. EWMA position document. London, MEP: 2001
• 12 Coulling S. Fundamentals of pain management in wound care. Brit J Nursing 2007; 16: 11
• 13 Hafner J, Nobbe S, Partsch H.. et al. Martorell Hypertensive ischemic leg ulcer. A model of ischemic subcutaneous arteriosclerosis. Arch Dermatol 2010; 146: 961-968.
• 14 Fredheim OMS. Clinical pharmacology of methadone for pain. Acta Anesthesiol Scand 2008; 52: 879
• 15 Finch PM, Knudsen L, Drummond PD. Reduction of allodynia in patients with complex regional pain syndrome: A double-blind placebo-controlled trial of topical ketamine. Pain 2009; 146: 18-25.
• 16 Wiffen PJ, Derry S, Moore RA. et al. Antiepileptic drugs for neuropathic pain and fibromyalgia – an overview of Cochrane reviews. Cochrane Database Syst Rev 2013; 11: CD010567.