Douleurs liées aux soins des plaies d'escarres ou d'ulcères

Pain related to the care of bedsore wounds or ulcers

Sep 28, 2021

The pain of wounds

Pain related to wound care has long been known and studied. Treatments feared by professionals and patients alike, these treatments, which are nevertheless necessary, have very bad press.

Why is treating a pressure sore or ulcer painful?

The pain associated with the bedsore can come from the bedsore itself or can occur during care, we then speak of iatrogenic pain. These treatments are painful when changing the dressing:
  • Cleaning the wound : the professionals carry out a cleaning of the wound, which even if it is carried out according to the rules of the art with physiological serum is painful. Taking an analgesic before the treatment is therefore recommended or the application of a local anesthetic before the treatment.
  • The dressings themselves cause pain :
    • Dressings that stick to the skin cause pain when peeling off .
    • The frequency of dressing renewal should be optimized so that the pain associated with dressing repair does not reoccur too often.
  • Changes in position during care also induce pain.

The consequences of pain on care and the caregiver/patient relationship

Unfortunately, these pains felt destroy the relationship of trust between the caregiver and the patient. Patients anticipate future pain and studies have shown that this makes them feel pain more intensely. They therefore fear more and more the arrival of caregivers for the realization of this wound care. This treatment is also feared by caregivers , for several reasons. Caregivers have generally chosen their profession with the aim of improving the condition of the person through their care. Nurses have written the fight against pain in the DNA of their profession. Nursing assistants, often very involved in the field of measures carried out to fight against the factors of aggravation of chronic wounds, are also directly concerned, during changes of position, during the performance of nursing care. “Risk of hurting” leads caregivers to modify their behavior for fear of hurting. Beyond felt guilt that cannot be denied, caregivers may also adopt avoidance strategies that ultimately undermine healing. In addition, the presence of a chronic wound such as a pressure ulcer is a marker of failure for caregivers in institutions, just like at home. It represents the failure of a set of preventive measures aimed at combating all the factors contributing to pressure ulcers. Even with the best care, healing from a chronic wound is slow . The duration of the treatment is indeed spread over several weeks, even several months .

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