Page 170 - Psychology of Wounds and Wound Care in Clinical Practice ( PDFDrive )

Dressing Change 145

It is well recognised that the chronic wound care regime
can be stressful, painful and socially isolating. The dress-
ing change may have to occur frequently and can result in
significant pain and anxiety for the individual patient. In
addition there are numerous forms of dressing, elements
involved in any dressing change along with a myriad of forms
of specialist treatment. Each of these elements may result in
concerns, social and psychological issues and potential dis-
tress. However, it is obviously impossible to do justice to all of
these and as such this chapter will explore just three elements
of wound care regimes: the stress and pain involved in dress-
ing change, the use of compression bandages and the use of
Negative Pressure Wound Therapy (NPWT).

Dressing Change

Wound pain and stress continue to be an important clini-
cal focus in wound care. In light of this, many consensus
documents and statements have been published to provide
healthcare professionals with best practice guidance on the
management of wound pain (WUWHS 2007 ). Specifically, the
pain caused by the removal of dressings has been identified
as a major contributor of wound pain (White 2008 ), from a
patient and healthcare professional perspective (Price et al.
2008b ; Kammerlander and Eberlein 2002 ). In particular,
a survey by Hollinworth and Collier ( 2000 ) indicated that
healthcare professionals were aware of the importance of pre-
venting pain during wound care, however they were unaware
of the types of dressings that can be used to minimise this. It
has been suggested that patients with wounds should have an
individual pain management plan, including regular review
and reassessment (Solowiej et al. 2010a , b ). It is therefore
important that particular attention is paid to dressing selec-
tion for patients on an individual basis, as it is known that poor
dressing choice can lead to increased wound pain.
Wound dressings have often been classified in simplistic
terms, with reference to the interaction that takes place