MAPP Observational Study: Painful Wounds and General Practice

Background: While wound healing is the main criterion used to evaluate the efficacy of a wound dressing, in most cases it will be the safety and acceptability outcomes which will determine the choice of the dressing.

Purpose: The aim of this survey was to determine the incidence of pain (“moderate to severe”) at dressing removal in patients presenting with acute and chronic wounds of various origins, and the effect of switching to a non-adherent dressing for the local treatment of these wounds. 

Methods: A prospective cohort survey was conducted with 656 outpatient PCP's. They reported the relevant details of all acute and chronic wounds seen in routine practice throughout the study period. The pain experienced during dressing changes was systematically evaluated. In patients with moderate to severe pain, a more extensive evaluation was performed and they were asked to document a self-evaluation questionnaire at each nursing care. A second questionnaire was documented by the physicians (initial and subsequent visit, when existing).  

Results: The MAPP survey involved 5850 outpatients presenting all types of wounds: 2914 acute wounds (traumatic, burns, post-operative wounds) and 2936 chronic wounds (ulcers, pressure-sores, diabetic ulcers). Prevalence of painful removal (“moderate to severe”) was similar in the two groups, acute and chronic wounds (79,9% and 79,7% respectively). The first cause of this painful removal was the adherence of the dressing to the wound bed and switching to the new prescribed non-adherent dressing (UrgoTul, based on the lipido-colloid technology (TLC). Laboratoires URGO) reduced pain at the dressing changes in 88% and 95% of the patients presenting chronic and acute wounds, respectively. 

Conclusion: This survey confirms that pain at dressing removal is a major issue, irrespective of the aetiology of the wound. Selection of a suitable and modern non-adherent dressing will dramatically improve patient’s acceptability.