title: The impact of atraumatic vs conventional dressings on pain and stress.
abstract: OBJECTIVE
  To compare the pain and stress experiences of patients with chronic wounds being treated with atraumatic vs conventional dressings at dressing change.
  
  
  METHODS
  This exploratory study adopted an independent samples design to identify any differences between reported levels of pain and stress associated with the use of atraumatic and conventional dressings used in treatment regimens of patients with chronic wounds. Physiological and psychological assessments of pain and stress were recorded at dressing change (including numerical ratings, heart rate, blood pressure, respiration rate, GSR, salivary cortisol and the Perceived Stress Scale (PSS) and State Trait Anxiety Inventory (STAI) questionnaire surveys).
  
  
  RESULTS
  In total, 49 patients with chronic wounds took part in the study. Fifty-three percent of patients were male (n=26) and 47% were female (n=23). Patients were aged 38-95 years, with a mean age of 69.11 ± 14.08 years. Overall, 10 patients were receiving atraumatic dressings with Safetac technology as part of their routine wound treatment and 39 were receiving conventional dressings. Patients receiving atraumatic dressings reported significantly lower numerical pain and stress ratings and experienced significantly lower GSR at dressing change. Mean heart rate, blood pressure, salivary cortisol were also lower for patients with atraumatic dressings. However, patients' PSS (atraumatic=24.60, conventional=22.72) and STAI (atraumatic=34.90, conventional=33.21) scores were similar for both dressing type groups.
  
  
  CONCLUSIONS
  This study provides a basis for understanding how different dressing types can impact pain and stress at dressing change. Acute episodes of pain and stress were much lower in patients receiving atraumatic dressings;0 however factors associated with the overall experience of living with a chronic wound may be contributing to underlying and ongoing feelings of stress and anxiety. The impact of these implications on selection of dressings and cost of care are also discussed.
  
  
  BACKGROUND
  This research was commissioned by Mölnlycke Health Care. None of the authors work for Mölnlycke Health Care of have any financial interests with the company. There are no additional conflicts of interest to declare.
authors.affiliation: Institute of Health and Society, University of Worcester, UK. d.upton@worc.ac.uk
authors.forename: D
authors.initials: D
authors.lastname: Upton
authors.forename: K
authors.initials: K
authors.lastname: Solowiej
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001458:Bandages; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000453:epidemiology* / Q000503:physiopathology; D013315:Stress, Psychological / Q000453:epidemiology* / Q000503:physiopathology; D014947:Wounds and Injuries / Q000628:therapy*