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Wound pain
Long-Term Care Nursing Advisor, June 30, 2006
Many elderly residents have at least one painful, chronic medical condition. Immobility, improper moving, friction and shearing often increase pain.
Open areas on the skin can be excruciatingly painful. Ineffective pain management results in delayed healing, lack of compliance, and prolonged care. Blood flow to the wound can be decreased during episodes of pain.
Pain subsides with healing in acute wounds. However, the protracted inflammatory response seen in chronic wounds may cause an increased sensitivity in the wound (primary hyperalgesia) and surrounding skin (secondary hyperalgesia). If the resident experiences additional pain during debridement, dressing changes, movement, etc., this may trigger allodynia, a condition in which ordinarily nonpainful stimuli cause pain.
Since wounds damage nerves, some residents may develop neuropathic pain, a condition in which the pain response is exaggerated. Minor sensations, such as air on a wound, light touch, or change in temperature will evoke intense pain. Other complications such as infection and ischemia may also contribute to the resident's pain response. Inadequate wound management contributes to wound pain.
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