Systematic review of topical interventions for the management of pain in chronic wounds
Abstract. Chronic wounds adversely affect quality of life. Pain is associated with chronic wounds, and its impact can vary according to wound aetiology, condition, and patient factors. This systematic review examined the effectiveness of topical interventions in the management chronic wound–related...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2023-09-01
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| Series: | PAIN Reports |
| Online Access: | http://journals.lww.com/painrpts/fulltext/10.1097/PR9.0000000000001073 |
| _version_ | 1797671771741093888 |
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| author | Cathal Ffrench David Finn Akke Velligna John Ivory Catherine Healy Karen Butler Duygu Sezgin Peter Carr Sebastian Probst Aonghus McLoughlin Sundus Arshad Caroline McIntosh Georgina Gethin |
| author_facet | Cathal Ffrench David Finn Akke Velligna John Ivory Catherine Healy Karen Butler Duygu Sezgin Peter Carr Sebastian Probst Aonghus McLoughlin Sundus Arshad Caroline McIntosh Georgina Gethin |
| author_sort | Cathal Ffrench |
| collection | DOAJ |
| description | Abstract. Chronic wounds adversely affect quality of life. Pain is associated with chronic wounds, and its impact can vary according to wound aetiology, condition, and patient factors. This systematic review examined the effectiveness of topical interventions in the management chronic wound–related pain guided by PRISMA recommendations of randomised controlled trials (RCTs) where pain reduction is the primary outcome. Inclusion criteria were adults (older than 18 years) with chronic venous, arterial, diabetic, or pressure ulcers where pain has been managed through topical administration of pharmacological/nonpharmacological agents. Searches were conducted in Ovid Embase, Ovid MEDLINE, EBSCOhost, CINAHL, CENTRAL, PubMed, Web of Science, and Scopus. Studies were screened for eligibility; risk of bias and data were extracted by 2 independent assessors. Searches retrieved 10,327 titles and abstracts (7760 after deduplication). Nine full texts (1323 participants) examining ibuprofen (n = 4), morphine (n = 2), BWD + PHMB [polihexanide-containing biocellulose wound dressing] (n = 1), and EMLA (n = 2) were included. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool. Meta-analysis was not possible, but initial exploration suggests improved outcomes (reduced pain) for ibuprofen when compared with controls. Two studies involving morphine showed conflicting findings. Included studies often had small samples, and considering confounding factors (eg, comorbidities), the results should be interpreted with caution. Review of included studies suggests that topical interventions may provide pain relief in individuals with chronic wounds. Further adequately powered RCTs are recommended to assess the efficacy of topical interventions for the management of chronic wound–related pain. |
| first_indexed | 2024-03-11T21:20:23Z |
| format | Article |
| id | doaj.art-e97aaeb375254dbfa99e5bb671e5b282 |
| institution | Directory Open Access Journal |
| issn | 2471-2531 |
| language | English |
| last_indexed | 2024-03-11T21:20:23Z |
| publishDate | 2023-09-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | PAIN Reports |
| spelling | doaj.art-e97aaeb375254dbfa99e5bb671e5b2822023-09-28T07:18:52ZengWolters KluwerPAIN Reports2471-25312023-09-0185e107310.1097/PR9.0000000000001073202309000-00008Systematic review of topical interventions for the management of pain in chronic woundsCathal Ffrench0David Finn1Akke Velligna2John Ivory3Catherine Healy4Karen Butler5Duygu Sezgin6Peter Carr7Sebastian Probst8Aonghus McLoughlin9Sundus Arshad10Caroline McIntosh11Georgina Gethin12a School of Nursing and Midwifery, University of Galway, Galway, Irelandb CÚRAM, SFI Research Centre for Medical Devices, Galway, Irelandf School of Public Health, Physiotherapy and Sports Science, University College Dublin (UCD), Dublin, Irelanda School of Nursing and Midwifery, University of Galway, Galway, Irelandb CÚRAM, SFI Research Centre for Medical Devices, Galway, Irelanda School of Nursing and Midwifery, University of Galway, Galway, Irelanda School of Nursing and Midwifery, University of Galway, Galway, Irelanda School of Nursing and Midwifery, University of Galway, Galway, Irelandi Geneva School of Health Science, HES-SO University of Applied Sciences and Arts, Western Switzerland, Geneva, Switzerland,g Alliance for Research and Innovation in Wounds, University of Galway, Galway, Irelandl Department of Medicine, University of Galway, Galway, Irelandg Alliance for Research and Innovation in Wounds, University of Galway, Galway, Irelanda School of Nursing and Midwifery, University of Galway, Galway, IrelandAbstract. Chronic wounds adversely affect quality of life. Pain is associated with chronic wounds, and its impact can vary according to wound aetiology, condition, and patient factors. This systematic review examined the effectiveness of topical interventions in the management chronic wound–related pain guided by PRISMA recommendations of randomised controlled trials (RCTs) where pain reduction is the primary outcome. Inclusion criteria were adults (older than 18 years) with chronic venous, arterial, diabetic, or pressure ulcers where pain has been managed through topical administration of pharmacological/nonpharmacological agents. Searches were conducted in Ovid Embase, Ovid MEDLINE, EBSCOhost, CINAHL, CENTRAL, PubMed, Web of Science, and Scopus. Studies were screened for eligibility; risk of bias and data were extracted by 2 independent assessors. Searches retrieved 10,327 titles and abstracts (7760 after deduplication). Nine full texts (1323 participants) examining ibuprofen (n = 4), morphine (n = 2), BWD + PHMB [polihexanide-containing biocellulose wound dressing] (n = 1), and EMLA (n = 2) were included. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool. Meta-analysis was not possible, but initial exploration suggests improved outcomes (reduced pain) for ibuprofen when compared with controls. Two studies involving morphine showed conflicting findings. Included studies often had small samples, and considering confounding factors (eg, comorbidities), the results should be interpreted with caution. Review of included studies suggests that topical interventions may provide pain relief in individuals with chronic wounds. Further adequately powered RCTs are recommended to assess the efficacy of topical interventions for the management of chronic wound–related pain.http://journals.lww.com/painrpts/fulltext/10.1097/PR9.0000000000001073 |
| spellingShingle | Cathal Ffrench David Finn Akke Velligna John Ivory Catherine Healy Karen Butler Duygu Sezgin Peter Carr Sebastian Probst Aonghus McLoughlin Sundus Arshad Caroline McIntosh Georgina Gethin Systematic review of topical interventions for the management of pain in chronic wounds PAIN Reports |
| title | Systematic review of topical interventions for the management of pain in chronic wounds |
| title_full | Systematic review of topical interventions for the management of pain in chronic wounds |
| title_fullStr | Systematic review of topical interventions for the management of pain in chronic wounds |
| title_full_unstemmed | Systematic review of topical interventions for the management of pain in chronic wounds |
| title_short | Systematic review of topical interventions for the management of pain in chronic wounds |
| title_sort | systematic review of topical interventions for the management of pain in chronic wounds |
| url | http://journals.lww.com/painrpts/fulltext/10.1097/PR9.0000000000001073 |
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