The WOCN Society 40th Annual Conference (June 21-25th, 2008)


2432

Examining the Evidence for a Drug-Free Dressing's Ability to Decrease Wound Pain

Roger C. Sessions, DO, FACEP, Ferris Mfg. Corp., Emergency Room Physician, Retired; CEO Ferris Mfg. Corp., 16W300 83rd Street, Burr Ridge, IL 60527

Purpose: Wound clinicians are becoming increasingly aware of the importance of pain management as an integral part of their patient treatment plans. Pain has been poorly addressed in the past, perhaps because systemic pain relievers do not always address wound pain well. Wound patients with multiple comorbidities are often poor candidates for systemic pharmaceutical pain relievers. Topical pharmaceutical pain relievers have been shown to have local side-effects that increase risk of infection and/or directly impair wound healing. This study will examine the scientific physiological explanation for clinician claims that polymeric membrane dressings often provide wound pain relief. Such drug-free pain relief could avoid the negative side-effects inherent in the use of currently available pharmaceutical agents.

Methodology: Two published scientific studies – an incisional study on a rodent model and a blunt trauma animal model – state that polymeric membrane dressings reduce nociceptor activity, which can result in significant pain relief. We examined these laboratory studies, along with over thirty published peer-reviewed patient case studies or case series attributing a reduction in wound pain to the use of polymeric membrane dressings, to determine the robustness of the evidence for using polymeric membrane dressings on painful wounds.

Statistics: This project is on-going. A meta-analysis of the data will be performed.

Results: Research demonstrates that polymeric membrane dressings inhibit the nociceptor response at the wound site. Published evidence states that the dressing might absorb sodium ions, by capillary action, from the skin and from the subcutaneous tissues. If this is true, then this local decrease in sodium ion concentration would result in reduced nociceptor nerve conduction, which could account for the observed pain relief and decreased edema, inflammation and inflammation-related ecchymosis both in animal models and in actual wound patients. Final conclusions await completion of the meta-analysis of the case studies and case series.