The improvement of wound-associated pain and healing trajectory with a comprehensive foot and leg ulcer care model.
OBJECTIVE
Pain is a major concern for subjects with chronic wounds, but its optimal management remains elusive. The aim of this study was to validate an organized pain management approach using the Wound Associated Pain model in subjects with chronic leg and foot ulcers.


METHODS
We completed a prospective cohort study that documented pain in chronic wound subjects over a 4-week period.


METHODS
A total of 111 subjects with chronic leg and foot ulcers were recruited from the community and ambulatory wound care clinics.


RESULTS
Using a systematic approach based on the Wound Associated Pain model, we demonstrated improved overall wound healing outcomes in 111 subjects with chronic leg and foot ulcers. Using an 11-point numerical rating scale, the average level of pain was reduced from 6.3 at week 0 to 2.8 at week 4 (P < .001). The average healing rate was 0.39 cm per week and the average relative reduction in size was 59.36% (t = 2.31; P = .023). To examine the relationship between pain and wound healing, pain levels were compared in subjects who achieved wound closure and those who did not. The mean pain score was 1.67 for the healed subjects in contrast to 3.21 for those who did not achieve complete wound closure (P < .041).


CONCLUSIONS
A comprehensive patient assessment can improve chronic leg and foot ulcer wound-related pain and healing rates. The mean pain scores are lower for patients with healed ulcers than for those who do not obtain complete wound closure.
Woo
K Y
KY
Clinical Scientist/Wound Care Specialist, Wound Healing Clinic, Women's College Hospital, Toronto, Ontario, Canada.
Sibbald
R G
RG
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015984:Causality; D003152:Community Health Nursing / Q000458:organization & administration; D005260:Female; D006699:Home Care Services; D006801:Humans; D007871:Leg Ulcer / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D016294:Models, Nursing; D009730:Nursing Assessment / Q000458:organization & administration*; D015403:Nursing Evaluation Research; D010146:Pain / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D010147:Pain Measurement; D018802:Patient-Centered Care; D011446:Prospective Studies; D012720:Severity of Illness Index; D017592:Skin Care / Q000009:adverse effects / Q000379:methods / Q000451:nursing; D053828:Stockings, Compression; D016896:Treatment Outcome; D014945:Wound Healing