The Improvement of Wound-Associated Pain and Healing Trajectory With a Comprehensive Foot and Leg Ulcer Care Model

Abstract

A comprehensive patient assessment can improve chronic leg and foot ulcer wound-related pain and healing rates. The mean pain scores are lower for patients with healed ulcers than for those who do not obtain complete wound closure.

Prevalence of pain and associated factors in venous ulcer patients

“…In our study, patients with smaller injuries had lower pain intensity and lower pain impact on quality of life. A study comparing pain intensity in patients with healed and open ulcers has shown that patients with healed ulcers had lower pain intensity 15 , thus confirming our findings. Our study has found association between VU-related pain and aspects of assistance and of the injury, which suggests that interventions focused on such factors could contribute to control those patients' pain.…”

“…This hypothesis, however, should be tested in future studies. Effective pain control brings unquestionable benefits to the quality of life of VU patients and there is a study indicating that adequate pain control also contributes to ulcer healing, which should also be tested in future studies 15 .…”

“…Pain is a very frequent symptom in VU patients and its prevalence varies from 80 to 96% [12][13][14] . It may be persistent and/or be exacerbated during dressing change 13,15 . In addition, pain negatively affects quality of life, generates mood instability, causes sleep disorders, changes mobility and ambulation, and increases the risk of falls 12,16,17 .…”

“…In addition, pain negatively affects quality of life, generates mood instability, causes sleep disorders, changes mobility and ambulation, and increases the risk of falls 12,16,17 . Pain may also negatively influence wound healing, because painful stimulation is associated to the release of inflammatory mediators which potentially impair tissue repair and regeneration 15 . Notwithstanding the relevance of this symptom, few studies have evaluated pain in VU patients.…”

Aspects Related to Venous Ulcer Healing and its Influence on Quality of Life

“…Pain stimulates the release of inflammatory mediators that interfere with repair tissue [21] and, when severe, it can be related to local infection, increasing healing time.…”