Ask the treatment expert ... how to manage painful wounds

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Susan Wickard, RN, BSN, CWCN, CWS, CLNC
Susan Wickard, RN, BSN, CWCN, CWS, CLNC

We continue this month on how to manage painful wounds.

As we've discussed, it is important to incorporate pain assessment into your routine wound assessment.

There are many interventions used to assist in pain reduction during dressing changes, which can include  (Hopf et al., 2012*):

• Minimizing degree of sensory stimulus (e.g., drafts from open windows, prodding and poking)

• Allowing the patient to perform own dressing changes

• Providing “time-outs” during painful procedures

• Scheduling dressing changes when patient is feeling best

• Giving an analgesic and then scheduling dressing change for time of drug's peak effect

• Soaking dried dressings before removal

• Avoiding the use of cytotoxic cleansers

• Avoiding aggressive packing

• Minimizing the number of dressing changes

• Preventing periwound trauma

• Positioning and supporting the wounded area for comfort

• Using low-adhesive or non-adhesive dressings

Topical lidocaine is another useful measure to reduce pain if dressing changes are painful. 

The important point is that pain needs to be addressed and not ignored.  

*Hopf, HW, et al, (editors):  Managing Wound Pain. Acute & Chronic Wounds, ed 4, St. Louis, MO, 2012. Page 381.