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Managing pain during the removal of wound dressings

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Many researchers have identified wound pain as a key factor in influencing a patient's quality of life from the social, economic, personal and psychological perspectives. Leg ulcers rank as the most painful type of wound, according to the European Wound Management Association.

Pain is defined by the International Association for the Study of Pain as: 'an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage', and both nociceptive and neuropathic pain are important to wound care.

Types of pain

Nociceptive pain is that which arises from actual or threatened damage to non-neural tissue and is due to the activation of a type of nerve called nociceptors. Nociceptive pain is an appropriate physiological response to a painful stimulus, including acute or chronic inflammation. It occurs as a result of tissue damage and is usually time-limited.

In chronic wounds with a prolonged inflammatory response there may be heightened sensitivity in both the wound (primary hyperalgesia) and in the surrounding skin (secondary hyperalgesia).1

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