Pain is the brain’s response to disease or to harmful agents in the body. There are three types of pain: nociceptive, neuropathic, and mixed pain (including nociceptive and neuropathic pain). Usually, acute wound pain is of the nociceptive type, while chronic wound pain is usually mixed pain.
Wound pain is the body’s response to tissue and cell damage, possibly due to trauma, due to care processes such as dressing change, wound washing, etc., or it can be combined with Background diseases such as ischemia, arthritis,… Wound pain greatly affects the patient’s quality of life as well as the healing process. Therefore, having knowledge about pain and knowing how to assess pain is important when caring for wounds.
Effect of wound pain
– Reduced quality of life : Wound pain greatly affects the daily life of patients. Injured people often have limited mobility and movement, especially in those with large wounds, chronic wounds. Not only that, wound pain also affects the patient’s psyche, making the patient stress, anxious and difficult to sleep, leading to loss of concentration, poor memory, and even depression in the long run.
Slow healing : Pain stimulates the body to release adrenaline and cortisol. Adrenaline has a vasoconstrictor effect, restricting blood circulation in the body, thereby limiting the source of nutrients to be supplied to the wound, making the healing process slower. Along with that, cortisol reduces the activity of the immune system such as reducing the activity of neutrophils and macrophages, which prolongs the inflammatory phase in the healing process, leading to healing time. injury is also prolonged.
Evaluation of wound pain
Proper pain assessment will help caregivers develop a care plan that is right for the patient. When assessing pain, the following criteria should be considered:
– Classification of pain : the patient’s pain is nociceptive, neuropathic or mixed.
– Time of pain : Since when does the patient have pain? How long does each pain last? pain frequency during the day?…
– Factors affecting pain : what factors make the patient less pain and what factors make the patient feel more pain.
– Location of pain : localized pain around the wound or pain in the whole body?
– Pain nature : sharp pain, diffuse pain, burning pain, dull pain, …
– Level of pain : There are many methods to assess and describe different levels of pain. Pain can be assessed according to the following criteria: no pain, mild pain, moderate pain, severe pain and great pain. Or you can rate it on a scale of 1-10 with 0 being no pain, 10 being the most pain the patient can tolerate. For patients who are unable to communicate such as people with dementia, children, mental illnesses, etc., there will be specialized assessment methods through manifestations such as breathing rate, sweating, facial expressions. face, body language…