Understanding the Origin of Wound Pain during Dressing Change

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The following is excerpted from Briggs M, Torra i Bou JE. Pain at wound dressing changes: a guide to management. European Wound Management Association Position Document. Pain at wound dressing changes. London, UK: Medical Education Partnership LTD; 2002.Used with permission.

  In a recent multinational survey, practitioners reported dressing removal to be the most painful aspect of the dressing procedure.1 This is particularly problematic where a dressing has stuck to the wound or removal of the dressing has torn the skin.2,3 Although practitioners are aware of issues surrounding wound pain, they often fail to manage pain effectively at dressing changes4 due to lack of knowledge and understanding of the underlying physiology responsible for the perception of pain. Misconceptions with regard to pain relative to ulcer size and type frequently undermine appropriate treatment. In addition, nurses may use social defenses such as "distancing" and "denial" to protect them from feeling overwhelmed about inflicting pain on their patients5; when used in excess, such strategies can result in poor practice.

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