Pain Management in Chronic Wound Care
Summary
Chronic wounds, including venous, arterial, diabetic and pressure ulcers, present a considerable burden on patients and healthcare systems worldwide. Pain in these wounds is multifactorial, encompassing nociceptive, inflammatory and neuropathic components that may fluctuate with wound status, dressing changes and comorbidities. Traditional management has relied heavily on systemic analgesics guided by severity scales, but concerns about polypharmacy, side effects and opioid dependency have fostered interest in targeted topical agents, physical therapies and psychosocial strategies. Debridement techniques and advanced dressings aim not only to optimise the healing environment but also to mitigate pain during procedures. Emerging approaches integrate biomarker assessment, multidisciplinary care pathways and patient-centred self-management, recognising the interplay between physiological processes and the emotional impact of persistent pain. Digital decision support tools and structured guidelines are increasingly employed to harmonise practice across settings and reduce variability in pain assessment. Effective management demands a balance of rigorous analgesic protocols with minimisation of systemic risk, while attending to individual patient preferences and global resource considerations.
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Pain Management in Chronic Wound Care publication trend
The graph below shows the total number of articles in pain management in chronic wound care across all publications each year (not limited to Nature Index journals).
Technical terms
Chronic wound: A skin lesion persisting for more than three months that resists normal healing processes.
Nociceptive pain: Pain arising from actual or threatened tissue damage activating peripheral nociceptors.
Neuropathic pain: Pain caused by lesion or disease of the somatosensory nervous system.
Debridement: The removal of non-viable tissue to promote wound healing and reduce pain.
Exudate: Fluid produced by a wound containing proteins, cells and metabolic by-products.
References
- Can Wound Exudate from Venous Leg Ulcers Measure Wound Pain Status?: A Pilot Study. PLOS ONE (2016).
- Patients ‘acceptance’ of chronic wound-associated pain – A qualitative descriptive study. Journal of Tissue Viability (2023).
- Health Care Staff’s Experiences of Engagement When Introducing a Digital Decision Support System for Wound Management: Qualitative Study. JMIR Human Factors (2020).
- The impact of decongestive physical therapy and elastic bandaging on the control of pain in patients with venous ulcers. Revista do Colégio Brasileiro de Cirurgiões (2018).
- Topical interventions for the management of pain in chronic wounds: A protocol for a systematic review. HRB Open Research (2022).
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