Free Nursing Dissertations - Pain Is One Of The Most Common Accompaniments Of Wounds And It Is Important
Pain is one of the most common accompaniments of wounds and it is important to understand whether pain relief has any relation whatsoever with wound healing. Pediani (2001) cite a study of 5150 hospital patients and found that 61% suffered pain due to wounds of which 87% had severe or moderate pain. Pain is considered to be of protective function as it warns of damage and initiates treatment. However postoperative pain can heighten cellular stress response; autonomic, somatic and endocrine reflexes are diminished resulting in a suppressed immune system which can impair wound healing.
In chronic wound management and tissue viability, wound bed preparation is a popular term describing the method of treatment. Vowden and Vowden (2002) describe that the concept of wound bed preparation represents a new direction in wound care thinking as wound management tend to focus both on the wound and on the patient necessitating a multidisciplinary and structured approach to care. Wound management focuses on the study of the interrelationship of functionally abnormal cells, bacterial balance, inappropriate biochemical messengers and dysfunctional wound matrix components. These elements are influenced by the patient's physical and psychological status and the aim of the wound bed preparation is to create optimal wound healing environment as well as vascularised and stable wound bed with no exudates. The five primary aspects of wound bed preparation include Restoration of bacterial balance, Management of necrosis, Management of exudates, Correction of cellular dysfunction and Restoration of biochemical balance (Vowden and Vowden, 2002).Vowden (2005) bring out the complicating factors in wound management and suggest that exudate, infection, co morbidity and polypharmacy constitute to a complex wound and a holistic assessment is necessary in wound care.
Pieper (2005) brings out the challenges faced by nurses in wound management and highlight the problems of wound management in rehabilitation patients as well as in vulnerable populations that are at risk. Rehabilitation nurses are challenged to understand issues that are related to working with vulnerable patients affected with wounds and these factors include poverty and payment for care, culture and literacy. Hampton (2004) emphasizes that preserving the skin's integrity in a patient is one of the primary jobs of a nurse and this can often be a complex and difficult task especially in cases of chronic wounds. Factors affecting the repair and management of chronic wounds also shed light on maintenance of skin integrity and general nursing needs in wound management.
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