Unremitting and recalcitrant pain is disabling and devastating in patients with chronic wounds.  Many patients living with chronic wounds identified pain to be their first and foremost concern.    The existential experience of living with chronic wound pain is complex and personal.  To document the lived experience of chronic wound pain, 4 focus groups (2 with leg ulcers patients and 2 with foot ulcers patients) were conducted to include 19 leg and foot ulcer patients.  Patients were asked to reflect on their experience of pain including characteristics of pain, quality of life issues, strategies to cope with pain, and barriers to effective pain management.  All interviews were videotaped.  Several major themes emerged linking pain and quality of life: pain had multiple characteristics; pain occurred with dressing change but also between dressing changes, pain affected family and social life; pain affected the personal sense of well-being; pain was difficult to manage; and pain management was influenced by the health care system.    Based on patients' description of pain, we also examined the model of the inner self (self-worth and anxiety regarding rejection) versus model of our perception of others (trust and avoidance of close relationship) according to the attachment framework.   Results were summarized into two orthogonal dimensions: discomfort with personal closeness and anxiety over relationships with others.  Health care providers need to recognize the importance of pain for patients with chronic wounds.  The pain experience can be modified by inner conflict (self-worth vs. anxiety) and external relationships with others (trusting relationships vs. alienation).

1. Dallam L. Smyth C. Jackson BS. Krinsky R. O'Dell C. Rooney J. Badillo C. Amella E. Ferrara L. Freeman K.  Pressure ulcer pain: assessment and quantification.  Journal of Wound, Ostomy, & Continence Nursing.  1995; 22(5): 211-5.

2. Szor JK.  Bourguignon C.  Description of pressure ulcer pain at rest and at dressing change.  J Wound Ostomy  & Cont Nursing.  1999; 26(3):115-20.

3. Meaume S. Teot L. Lazareth I. Martini J. Bohbot S.  The importance of pain reduction through dressing selection in routine wound management: the MAPP study.  Journal of Wound Care.  2004; 13(10): 409-13.

4. Quirino J, Santos VLC, Quednau TJP, Martins APF, Lima P, Almeida MRM. Pain in pressure ulcers. Wounds. 2003; 15(12): 381-9