Assessment and management of pain in fungating wounds

Pain is a complex phenomenon that affects individuals in different ways. Wound pain is often seen as an inevitable consequence of wound care and many patients may suffer from chronic wound pain. One group of patients that presents a challenge in wound pain management are those with fungating malignant wounds. The effective management of wound pain may be compromised by inappropriate or non-existent pain assessment, the inefficient prescribing of analgesia, and confusion about the appropriate use of dressing products to reduce wound pain. Many healthcare professionals lack knowledge about pain and pain control and hold inappropriate beliefs and attitudes about analgesic medications, in particular relating to opioid drugs. This article aims to address these issues by providing a brief overview of pain physiology followed by strategies for pain assessment and options for the management of pain related to fungating wounds, including pharmacological treatments, wound care techniques and complementary therapies.