title: Evidence-based approach to manage persistent wound-related pain.
abstract: OBJECTIVE
  Pain is a significant concern in people with chronic wounds. A systematized approach is recommended for the management of wound-associated pain with the objectives to address pain relief, increase function, and restore overall quality of life.
  
  
  RESULTS
  Combinations of pharmacological agents are often recommended based on varying degree of pain severity, coexisting nociceptive and neuropathic pain, and chronic inflammation related to wound-associated pain. Topical agents including morphine, tricyclic antidepressants (e.g., amitriptyline), nonsteroidal anti-inflammatory drugs (NSAIDs), capsaicin, ketamine, and lidocaine/prilocaine provide pain relief with minimal side effects. Mindful dressing selection to minimize trauma, handle excess fluid, and prevent periwound skin damage has been shown to reduce persistent wound pain. To avoid nocebo hyperalgesia, it is important to address emotions, anticipation or negative expectation of discomfort.
  
  
  CONCLUSIONS
  Pain is a complex biopsychosocial phenomenon that requires multiple pharmacological and nonpharmacological management approach.
authors: School of Nursing, Queen's University, Kingston, Ontario, Canada. kevin.woo@queensu.ca
authors: Kevin Y
authors: KY
authors: Woo
authors: Laura K
authors: LK
authors: Abbott
authors: Lawrence
authors: L
authors: Librach
mesh_terms: D000700:Analgesics / Q000008:administration & dosage / Q000009:adverse effects / Q000145:classification; D059390:Breakthrough Pain / Q000209:etiology / Q000523:psychology / Q000628:therapy; D059350:Chronic Pain / Q000209:etiology / Q000523:psychology / Q000628:therapy; D055317:Evidence-Based Practice; D006801:Humans; D009437:Neuralgia / Q000209:etiology / Q000523:psychology / Q000628:therapy*; D059226:Nociceptive Pain / Q000209:etiology / Q000523:psychology / Q000628:therapy*; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement / Q000379:methods; D010353:Patient Education as Topic / Q000379:methods; D026741:Physical Therapy Modalities; D011613:Psychotherapy / Q000379:methods; D012720:Severity of Illness Index; D014947:Wounds and Injuries / Q000150:complications* / Q000523:psychology / Q000628:therapy
chemical_list: D000700:Analgesics