| 33 |
Oral Abstracts (Session 2 of 5)
|
(Presentation 33.4) Treatment of painful skin ulcers with a biocellulose dressing containing lidocaine Oscar Alvarez, PhD, Roisin Rogers, RN, MSN, CWCN; Juanita Booker, RN, BSN, Visiting Nurse Service of New York, Bronx, NY; Mayank Patel, MD, East Tremont Vascular Center, LLC, Bronx, NY Background: The quantitative assessment of chronic pain is a challenging problem because it is both multidimensional and subjective. Pain intensity is considered to be one of the most clinically relevant dimensions of the pain experience. In interventional studies, unidimensional pain measurement tools should be used to assess pain. Objective: The objective of this study was to determine whether a dressing containing lidocaine 4% is more effective than simple occlusion with the dressing alone (control) in reducing localized pain in chronic wounds. Setting: The setting of the study was an outpatient wound care center specializing in the treatment of lower leg ulcers. Subjects: Thirty-two ambulatory patients with painful lower leg ulcers of varying etiologies were included in the study. Interventions: A single application of a biocellulose dressing* containing 4% lidocaine or the control dressing (the biocellulose dressing without lidocaine) was applied to the ulceration. Main Outcome Measures: Pain was assessed at 4, 8, 12, and 24 hours after dressing application using 2 different clinically validated scales: 1) 100-mm visual analogue scale (VAS); and 2) numerical pain score/pain relief scale. Results: Pain intensity was significantly lower (P < 0.05) after treatment with the lidocaine wound dressing at every evaluation point as determined with both VAS (P = 0.005 at 24 hours) and numerical scales (P = 0.044 at 24 hours). Subjects treated with the control reported less pain after 8 and 12 hours (P < 0.05). Conclusion: The VAS is considered ideal because it is continuous and independent from language; however, its validity depends strongly on instructions given to the subjects. Numerical pain relief and numerical pain score ratings more accurately reflect an analgesic response and are easier to apply. A single application of lidocaine 4% wound dressing was effective in reducing localized wound pain. Pain relief was rapid and long lasting. *X-Cell Wound Dressing, Xylos Corporation, Langhorne, Pa, Medline Industries, Mundelein, Ill References Littman GS, Walker BR, Schneider, BE. Reassessment of verbal and visual analogue ratings in analgesic studies. Clin Pharmacol Ther 1985;38:16–23 Caraceni A, Cherny N, Fainsinger R, et al. Pain measurement tools and methods in clinical research in palliative care. J Pain Symptom Manage 2002; 23:239–55 |
|