Addressing the pain: understanding the origins of wound pain during dressing change

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.