Chapter 3: Chronic Wound Pain: An Undermanaged Patient Concern

Authors:

• Douglas Queen, BSc, PhD, MBA
• Laurie Goodman, RN, MHScN, IIWCC (CAN)
• Reneeka Jaimangal, MD, MScCH, IIWCC (CAN)
• Ramesh Zacharias, MD, FRCS (C)
• R. Gary Sibbald, BSc. Md. M.Ed., D.SC (Hon), FRCPC (Med)(Derm), FAAD, MAPWCA, JM

Summary

Chronic wound pain is distressing and influences the patient’s ability to function (Ren et al, 2021). One of the failures of modern medicine is the inadequate assessment and treatment of pain. The clinician’s approach to chronic wound pain combines the ‘preparing the wound bed’ paradigm with chronic wound care pain management (Sibbald et al, 2021). A holistic approach must include the diagnosis and treatment of the underlying cause, identification, and correction of patient centered concerns, and the four components of local wound care (DIME: Debridement, Infection / Inflammation, Moisture management, Edge effect).

Securing a thorough pain history focusing on pain patterns will facilitate healthcare professionals develop specific pain relief initiatives (Leren et al, 2020). Pain is a component of quality of life (a tool to measure general disabilities) that is reflected in activities of daily living. Patient centered concerns need to address pain control measures until the cause of the pain can be identified. Controlling pain, however, may not always improve activities of daily living. Each of the components of local wound care may also be responsible for pain; strategies need to be implemented to ensure adequate patient comfort.