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Abstract

As noted in other chapters, chronic wounds may cause financial, emotional and psychological strain for the patient. However, it is not just the wound that can cause these problems- it may also be the treatment for their wound. This chapter explores some of the psychological issues related to the treatment for chronic wounds, detailing three particular areas of treatment. Firstly, the stresses and strains of dressing change are explored. This highlights how the pain and stress may be associated with the dressing regime and, how, changing to an appropriate dressing choice may reduce both pain and stress. In such a way it may be possible to improve healing by reducing the stress associated with inappropriate dressing technique. Secondly, compression therapy will be explored and how concordance with this may be low and thereby reducing the effectiveness of the treatment. Techniques to improve concordance with treatment will also be explored. Finally, the pain and stress of Negative Pressure Wound Therapy (NPWT) will be outlined and how this may change across the course of treatment- emphasising the need to assess psychological variables throughout the course of any health related intervention.

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References

  • Abbade LPF, Lastoria S, Rollow HD, Stolf HO. A socio-demographic, clinical study by patients with venous ulcer. Int J Dermatol. 2005;44(12):989–92.

    Article  PubMed  Google Scholar 

  • Abbotts J. Patients’ views on topical negative pressure: ‘effective but smelly’. Br J Nurs. 2010;19(20):S37–41.

    Article  PubMed  Google Scholar 

  • Anand SC, Dean C, Nettleton R, Praburaj DV. Health-related quality of life tools for venous-ulcerated patients. Br J Nurs. 2003;12(1):48–59.

    Article  CAS  PubMed  Google Scholar 

  • Annells M, O’Neill J, Flowers C. Compression bandaging for venous leg ulcers: the essentialness of a willing patient. J Clin Nurs. 2008;17(3):350–9. doi:10.1111/j.1365-2702.2007.01996.x.

    Article  PubMed  Google Scholar 

  • Apostoli A, Caula C. Pain and basic functional activities in a group of patients with cutaneous wounds under VAC therapy in hospital setting (in Italian). Prof Inferm. 2008;61:158–64.

    PubMed  Google Scholar 

  • Ashby RL, et al. Clinical and cost-effectiveness of compression hosiery versus compression bandages in treatment of venous leg ulcers (Venous leg Ulcer Study IV, VenUS IV): a randomised controlled trial. Lancet. 2014;383:871–9.

    Article  PubMed  Google Scholar 

  • Assenza M, Cozza V, Sacco E, et al. VAC (Vacuum Assisted Closure) treatment in Fournier’s gangrene: personal. Clin Ter. 2011;162(1):e1–5.

    CAS  PubMed  Google Scholar 

  • Augustin M, Zschocke I, Nutzenbewertung der Ambulanten und Stationären VAC. Therapie aus Patientensicht: Multicenterstudie mit Patientenrelevanten Endpunkten [Patient evaluation of the benefit of outpatient and inpatient vacuum therapy. Multicenter study with patient-relevant end points]. MMW Fortschritte der Medizin Originalia. 2006;148(1):25–32.

    Google Scholar 

  • Barwell JR, Taylor M, Deacon J, Davies C, Whyman MR, Poskitt KR. Ankle motility is a risk factor for healing of chronic venous Leg ulcers. Phlebology. 2001;16:38–40.

    Article  Google Scholar 

  • Bolas N, Holloway S. Negative pressure wound therapy: a study on patient perspectives. Br J Community Nurs. 2012;17(3):S30–5.

    Article  Google Scholar 

  • Briggs M, Flemming K. Living with leg ulceration: a synthesis of qualitative research. J Adv Nurs. 2007;59(4):319–28.

    Article  PubMed  Google Scholar 

  • Briggs M, Bennett MI, Closs SJ, Cocks K. Painful leg ulceration: a prospective, longitudinal cohort study. Wound Repair Regen. 2007;15(2):186–91.

    Article  PubMed  Google Scholar 

  • Bryan S, Dukes S. Case study: negative pressure wound therapy in an abdominal wound. Br J Nurs. 2009;18(2):S15–21.

    Article  PubMed  Google Scholar 

  • CREST. Clinical resource efficiency support team: guidelines for the assessment and management of Leg ulceration. Belfast: CREST; 1998.

    Google Scholar 

  • Dereure O, Vin F, Lazareth I, Bohbot S. Compression and peri-ulcer skin in outpatients’ venous leg ulcers: results of a French survey. J Wound Care. 2005;14(6):265–71.

    Article  CAS  PubMed  Google Scholar 

  • Edwards LM. Why patients do not comply with compression bandaging. Br J Nurs. 2003;12(Suppl):S5S16.

    Google Scholar 

  • Feben K. How effective is training in compression bandaging techniques? Br J Community Nurs. 2003;8(2):80–4.

    Article  PubMed  Google Scholar 

  • Field H. Fear of the known? District nurses practice of compression bandaging. B J Comm Nurs. 2004;(Suppl Dec):6S-15S.

    Google Scholar 

  • Finlayson K, Edwards H, Courtney M. Factors associated with recurrence of venous leg ulcers: a survey and retrospective chart review. Int J Nurs Stud. 2009;46(8):1071–8.

    Article  PubMed  Google Scholar 

  • Hollinworth H, Collier M. Nurses’ views about pain and trauma at dressing changes: results of a national survey. J Wound Care. 2000;9(8):369–73.

    Article  CAS  PubMed  Google Scholar 

  • Hopkins A. Ignoring lower limb oedema will lead to ineffective care. Wounds UK. 2008;4:3.

    Google Scholar 

  • Jull A, Walker N, Hackett M, et al. Leg ulceration and perceived health: a population based case-control study. Age Ageing. 2004a;33(3):236–41.

    Article  PubMed  Google Scholar 

  • Jull G, Kristjansson E, Dall’Alba P. Impairment in the cervical flexors: a comparison of whiplash and insidious onset neck pain patients. Man Ther. 2004b;9:89–94.

    Article  CAS  PubMed  Google Scholar 

  • Kammerlander G, Eberlein T. Nurses’ views about pain and trauma at dressing changes: a central European perspective. J Wound Care. 2002;11(2):76–9.

    Article  CAS  PubMed  Google Scholar 

  • Karatepe O, Eken I, Acet E, et al. Vacuum assisted closure improves the quality of life in patients with diabetic foot. Acta Chir Belg. 2011;111(5):298–302.

    CAS  PubMed  Google Scholar 

  • Keskin M, Karabekmez FE, Vilmaz E. Vacuum-assisted closure of wounds and anxiety. Scand J Plast Reconstr Surg Hand Surg. 2008;42:202–5.

    Article  PubMed  Google Scholar 

  • King B, Wesley V, Smith R. An audit of footwear for patients for patients with leg bandages. Nurs Times. 2007;103:40–3.

    PubMed  Google Scholar 

  • Kroger K, Assenheimer B. Consensus recommendation: recommendations for compression therapy for patients with venous ulcers. EWMA. 2013;13(2):41–7.

    Google Scholar 

  • Mendonca DA, Drew PJ, Harding KG, et al. A pilot study on the effect of topical negative pressure on quality of life. J Wound Care. 2007;16(2):49–53.

    Article  CAS  PubMed  Google Scholar 

  • Miller C, Kapp S, Newall N, et al. Predicting concordance with multilayer compression bandaging. J Wound Care. 2011;20(3):101–2, 104, 106 Passim.

    Article  CAS  PubMed  Google Scholar 

  • Milne J. 1: Improving wellbeing of those living with a wound. Br J Nurs. 2013;22:3–9.

    Article  Google Scholar 

  • Moffatt MF. SPINK5: a gene for atopic dermatitis and asthma. Clin Exp Allergy. 2004a;34:325–7.

    Article  CAS  PubMed  Google Scholar 

  • Moffatt CJ. Factors that affect concordance with compression therapy. J Wound Care. 2004b;13(7):291–6.

    Article  CAS  PubMed  Google Scholar 

  • Moffatt C, Kommala D, Dourdin N, Choe Y. Venous leg ulcers: patient concordance with compression therapy and its impact on healing and prevention of recurrence. Int Wound J. 2009;6:386–93.

    Article  PubMed  Google Scholar 

  • Mudge E, Holloway S, Simmonds W, Price P. Living with venous leg ulceration: issues concerning adherence. Br J Nurs. 2006;15(21):1166–71.

    Article  PubMed  Google Scholar 

  • Nease C. Using low pressure, NPWT for wound preparation & the management of split-thickness skin grafts in 3 patients with complex wound. Ostomy Wound Manage. 2009;55(6):32–42.

    PubMed  Google Scholar 

  • Nelson EA. The development of a training device for users of medical compression bandages used in the treatment of chronic venous ulcers type of submission: Contributed paper type of presentation: oral presentation conference: 2012 IEEE/ASME international conference on advanced intelligent mechatronics submission number: 4. In: Conference on advanced intelligent mechatronics, Taiwan, 2012.

    Google Scholar 

  • O’Meara S, et al. Four layer bandage compared with short stretch bandage for venous leg ulcers: systematic review and meta-analysis of randomised controlled trials with data from individual patients. BMJ. 2009;338:b1344.

    Article  PubMed Central  PubMed  Google Scholar 

  • Ousey K, Bianchi J, Beldon P, Young T. Identification and treatment of moisture lesions. Wounds UK (Suppl). 2012. Available from: www.wounds-uk.com.

  • Panicker VN. A pilot study evaluating topical negative pressure using V1STA technology. Wound Pract Res. 2009;17(4):194.

    Google Scholar 

  • Parvaneh S, Grewal GS, Grewal E, Menzies RA, Talal TK, Armstrong DG, Sternberg E, Najafi B. Stressing the dressing: Assessing stress during wound care in real-time using wearable sensors. Wound Med. 2014;4:21–6.

    Article  Google Scholar 

  • Price JR, Mitchell E, Tidy E, Hunot V. Cognitive behaviour therapy for chronic fatigue syndrome in adults. Cochrane Database Syst Rev. 2008a;(3):CD0010207.

    Google Scholar 

  • Price PE, Fagervik-Morton H, Mudge EJ, Beele H, Conteras Ruiz J, Huldt Nystrom T, Harding KG. Dressing- related pain in patients with chronic wounds: an international patient perspective. Int Wound J. 2008b;5(2):159–71.

    Article  PubMed  Google Scholar 

  • Puffett N, Martin L, Chow MK. Cohesive short-stretch vs four-layer bandages for venous leg ulcers. Br J Community Nurs. 2006;11(6):S6, S8, S10–1.

    Article  PubMed  Google Scholar 

  • Randell R, Mitchell N, Thompson C, McCaughan D, Dowding D. Supporting nurse decision making in primary care: exploring use of and attitude to decision tools. Health Informatics J. 2009;15(1):5–16.

    Article  PubMed  Google Scholar 

  • Rippon M, Davies P, White R, Bosanquet N. Cost implications of using an a-traumatic dressing in the treatment of acute wounds. J Wound Care. 2008;17(5):224–7.

    Article  CAS  PubMed  Google Scholar 

  • Royal College of Nursing. The nursing management of patients with venous leg ulcers. London: RCN; 2006.

    Google Scholar 

  • Sadler GM, Russell GM, Boldy DP, Stacey MC. General practitioners’ experiences of managing patients with chronic leg ulceration. Med J Aust. 2006;185(2):78–81.

    PubMed  Google Scholar 

  • Satpathy A, Hayes S, Dodds SR. Measuring sub-bandage pressure: comparing the use of pressure monitors and pulse oximeters. J Wound Care. 2006;15(3):125–8.

    Article  CAS  PubMed  Google Scholar 

  • Schimp VL, Worley C, Brunello S, et al. Vacuum-assisted closure in the treatment of gynecologic oncology wound failures. Gynecol Oncol. 2003;92:586–91.

    Article  Google Scholar 

  • SIGN. The care of patients with chronic leg ulcer. 1998. http://www.sign.ac.uk/guidelines/index.html.

  • Solowiej K, Mason V, Upton D. Psychological stress and pain in wound care, part 3: management. J Wound Care. 2010a;19(4):153–5.

    Article  CAS  PubMed  Google Scholar 

  • Solowiej K, Mason V, Upton D. Psychological stress and pain in wound care, part 2: a review of pain and stress assessment tools. J Wound Care. 2010b;19(3):110–5.

    Article  CAS  PubMed  Google Scholar 

  • Stansby G, Wealleans V, Wilson L, Morrow D, et al. Clinical experience of a new NPWT system in diabetic foot ulcers and post-amputation wounds. J Wound Care. 2010;19(11):496.

    Article  CAS  PubMed  Google Scholar 

  • Stephen-Haynes J. An overview of compression therapy in leg ulceration. Nurs Stand. 2006;20(32):68–76.

    Article  PubMed  Google Scholar 

  • Templeton S, Telford K. Diagnosis and management of venous leg ulcers: a nurse’s role? Wound Pract Res. 2010;18(2):72–9.

    Google Scholar 

  • Thomas S. The use of the Laplace equation in the calculation of sub-bandage pressure. EMWA J. 2003;3(1). Available from URL: http://www.worldwidewounds.com/2003/june/Thomas/Laplace-Bandages.htm.

  • Todd M. Venous leg ulcers and the impact of compression bandaging. Br J Nursing. 2011;20(21):1360–4.

    Article  Google Scholar 

  • Todd M. Chronic oedema: impact and management. Br J Nurs. 2013;22(11):623–7.

    Article  PubMed  Google Scholar 

  • Ubbink DT, Westerbos SJ, Evans D, Land L, Vermeulen H. Topical negative pressure for treating chronic wounds. Cochrane Database Syst Rev. 2008;(3):CD001898.

    Google Scholar 

  • Upton D, Andrews A. Negative pressure wound therapy: improving the patient experience, part two of three. J Wound Care. 2013a;22(11):582–91.

    Article  CAS  PubMed  Google Scholar 

  • Upton D, Andrews A. Negative pressure wound therapy: improving the patient experience, part one of three. J Wound Care. 2013b;22(10):552–7.

    Article  CAS  PubMed  Google Scholar 

  • Upton D, Andrews A. Pain and trauma in negative pressure wound therapy: a review. Int Wound J. 2013c; Advance online publication.

    Google Scholar 

  • Upton D, Solowiej K. The impact of a traumatic vs conventional dressings on pain and stress. J Wound Care. 2012;21(5):209–15.

    Article  CAS  PubMed  Google Scholar 

  • Upton D, Hender C, Solowiej K. Mood disorders in patients with acute and chronic wounds: a health professional perspective. J Wound Care. 2012a;21(1):42–8.

    Article  CAS  PubMed  Google Scholar 

  • Upton D, Hender C, Solowiej K, Woo K. Stress and pain associated with dressing change in chronic wound patients. J Wound Care. 2012b;22(2):53–61.

    Article  Google Scholar 

  • Upton D, Solowiej K, Hender C, Woodyat KY. Stress and pain associated with dressing change in patients with chronic wounds. J Wound Care. 2012c;21(2):53–61.

    Article  CAS  PubMed  Google Scholar 

  • Van Hecke AV, Mundy P, Acra F, Block J, Delgado CEF, Parlade MV, et al. Infant joint attention, temperament, and social competence in preschool children. Child Dev. 2007;78(1):53–69.

    Article  PubMed Central  Google Scholar 

  • Verbelen J, Hoeksema H, Heyneman A, Pirayesh A, Monstrey S. Treatment of Fournier’s gangrene with a novel negative pressure wound therapy system. Wounds. 2011;23(11):342–9.

    Google Scholar 

  • Wallin AM, Bostrom L, Ulfvarson J, Ottoson MD. Negative pressure wound therapy: a descriptive study. Ostomy Wound Manage. 2011;57(6):22–9.

    PubMed  Google Scholar 

  • Weller CD, Buchbinder R, Johnston RV. Interventions for helping people adhere to compression treatments for venous leg ulceration. Cochrane Database Syst Rev. 2013;(9):CD008378.

    Google Scholar 

  • White R. A multinational survey of the assessment of pain when removing dressings. Wounds UK. 2008;4(1):1–6.

    Google Scholar 

  • Wolvos T. Wound instillation – the next step in negative pressure wound therapy. Lessons learned from initial experiences. Ostomy Wound Manage. 2004;50(11):56–66.

    PubMed  Google Scholar 

  • World Union of Wound Healing Societies. Principles of best practice: wound exudate and the role of dressings. A consensus document. London: MEP; 2007.

    Google Scholar 

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Upton, D., Upton, P. (2015). Treatment. In: Psychology of Wounds and Wound Care in Clinical Practice. Springer, Cham. https://doi.org/10.1007/978-3-319-09653-7_6

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  • DOI: https://doi.org/10.1007/978-3-319-09653-7_6

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