title: Dressing-related pain in patients with chronic wounds: an international patient perspective.
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 = 15.4) participated. The wounds were categorised into ten different types with a mean wound duration of 19.6 months (SD = 51.8). For 2018 patients, 3361 dressings/compression systems were being used, with antimicrobials being reported most frequently (n= 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= 0.002). All patients reported that 'the wound itself' was the most painful location (n= 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 = 30.5, n= 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= 1898). In terms of different types of daily activities, 'overdoing things' was associated with the highest mean score (mean = 2.6, n= 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= 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.
authors.affiliation: Department of Wound Healing, School of Medicine, Cardiff University, Cardiff, UK. pricepe@cardiff.ac.uk
authors.forename: Patricia E
authors.initials: PE
authors.lastname: Price
authors.forename: Hilde
authors.initials: H
authors.lastname: Fagervik-Morton
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Mudge
authors.forename: Hilde
authors.initials: H
authors.lastname: Beele
authors.forename: Jose Contreras
authors.initials: JC
authors.lastname: Ruiz
authors.forename: Theis Huldt
authors.initials: TH
authors.lastname: Nystrøm
authors.forename: Christina
authors.initials: C
authors.lastname: Lindholm
authors.forename: Sylvie
authors.initials: S
authors.lastname: Maume
authors.forename: Britta
authors.initials: B
authors.lastname: Melby-Østergaard
authors.forename: Yolanda
authors.initials: Y
authors.lastname: Peter
authors.forename: Marco
authors.initials: M
authors.lastname: Romanelli
authors.forename: Salla
authors.initials: S
authors.lastname: Seppänen
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Serena
authors.forename: Gary
authors.initials: G
authors.lastname: Sibbald
authors.forename: Jose Verdú
authors.initials: JV
authors.lastname: Soriano
authors.forename: Wendy
authors.initials: W
authors.lastname: White
authors.forename: Uwe
authors.initials: U
authors.lastname: Wollina
authors.forename: Kevin Y
authors.initials: KY
authors.lastname: Woo
authors.forename: Carolyn
authors.initials: C
authors.lastname: Wyndham-White
authors.forename: Keith G
authors.initials: KG
authors.lastname: Harding
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001458:Bandages / Q000009:adverse effects*; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D003646:Debridement / Q000009:adverse effects; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology* / Q000517:prevention & control; D010147:Pain Measurement; D014947:Wounds and Injuries / Q000150:complications / Q000628:therapy*