An accurate wound assessment and diagnosis, as described in previous blog posts, is vital for understanding the origin and extent of the wound pain. Once the pain has been fully investigated, pain management strategies can be put into place.
Underlying Cause = Underlying Source
many cases, the underlying cause of the wound is also the underlying source of the pain. The first stage in wound pain management should be to identify the cause of the wound and treat according to standard protocols. For example, pain occurring through orthostatic venous edema may be relieved by leg elevation, compression therapy or exercise, while pain resulting from a pressure ulcer may be eased by regular repositioning, mobilization or the use of appropriate support surfaces. Infection and inflammation are also common causes of wound pain, and should be managed as a priority according to standard procedures.
Local Causes
Once the underlying cause of the wound has been managed, local wound care issues that also contribute to the pain be addressed. Local causes of wound pain may include improper moisture balance in the wound or procedures such as debridement, wound cleansing or the removal of dressings.
Local wound care practices can have a significant effect on the level of pain a patient experiences, in either a negative or a positive way. Very simple, intuitive pain relief strategies can be introduced which, although easily overlooked, make a huge difference to the experience of the patient.
Pressure-Reduction
The use of pressure-reduction support surfaces, which conform to the body contours to relieve pressure and promote a healthy microclimate, can also have a dramatic and beneficial effect on the level of pain experienced by the patient. In addition, therapeutic support surfaces, which improve tissue perfusion by minimizing tissue compression, should be considered for patients with trunk wounds who are bed-bound.
Layer Wound Pain Management
After the underlying cause of the wound has been addressed and local wound care management strategies put into place, specific analgesic approaches should be adopted. Optimal wound-related pain management may be based on a combination of pharmacological and non-pharmacological interventions, administered both locally and systemically.
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