Meeting the challenges of wound-associated pain: anticipatory pain, anxiety, stress, and wound healing.

摘要: P ain is an unpleasant physical and emotional experience that plays a key role in the lives of people with chronic wounds. It well documented majority patients wounds suffer from moderate to severe pain for protracted period time frequent exacerbations. Although often associated conditions intrinsic underlying etiologies (eg, acute lipodermatosclerosis venous leg ulcers, Charcot changes diabetic foot ulcers), trauma (pressure, shear, friction), chemical irritation, infection, or inflammation, spontaneous may occur due sensitization nerve fibers. In studies conducted during dressing changes, describe most excruciating at removal as aggressive adhesives are peeled away fragile damaged periwound skin. Increasing evidence also validates wound cleansing, especially when abrasive materials forceps used remove debris bed. To raise awareness promote systemic approach managing pain, Woo Sibbald developed wound-associated (WAP) model highlights three components: wound, cause, patient (see Figure 1). First, cause must be treated. Second, local care issues exacerbate woundassociated addressed. These include tissue (dressing cleansing); moisture balance (too much can skin maceration erosion while too little dries out then tends adhere bed); infection/inflammation (increased warning sign potential deep infection); patient-centered concerns anxiety, depression, anticipation pain). Meeting Challenges Wound-associated Pain: Anticipatory Pain, Anxiety, Stress, Wound Healing