The effect of Ringer's solution within a dressing to elicit pain relief

Clinical studies suggest that dressings containing Ringer's solution, such as the TenderWet and HydroClean families, provide relief from wound pain. This report reviews the available evidence and possible mechanisms for the relief of wound pain by these dressings. The ability of dressings containing Ringer's solution to provide pain relief is likely to be through providing a moist environment that is favourable for wound healing; furthermore, the dressing augments the protective barrier function by having additional fluid under the dressing, which covers exposed nerve endings and protects against friction damage. Ringer's solution will have a dilution effect and an influence on the pH of exudate. Diluting cytokines within the exudate would be expected to decrease inflammation in chronic wounds and reduce the influence of caustic components such as matrix metalloproteases (MMPs). Altering the pH of the wound bed could inactivate proteins and glycoproteins implicated in the pain response such as MMPs and sodium and calcium channels. The moist environment may also be better at recruiting leukocytes that release natural painkillers at areas of injury. These mechanisms are likely to act in combination to explain why dressings containing Ringer's solution can have analgesic effects.