Surgical wound pain: a trial of two treatments

In order to compare postoperative incisional pain intensity, a prospective randomised controlled trial was conducted with two patient groups: a treatment group (treated with a film dressing left intact until suture removal) and a control group (treated with the existing wound-care protocol of a dry dressing removed after 48 hours). Patient-controlled analgesia consumption and infection rates in the two groups were also compared. A sample of 30 patients undergoing total abdominal hysterectomy was selected. Incisional wound pain, measured using a visual analogue scale (at rest, on movement and a 24-hour average) and the McGill Pain Questionnaire were recorded daily until discharge (four days). The pain scores were not significantly different between the groups on Days 1 or 2 postoperatively. However, on Day 3 (when the wounds in the dry dressing group were exposed), there was a statistically significant difference in 24-hour average pain. Those whose wounds were covered with the film dressing experienced less pain and requested fewer non-steroidal anti-inflammatory drugs on Day 3. Maintaining a cover over a surgical wound until suture removal appears to promote pain relief when compared to exposing wounds to the air. A film dressing was useful in this respect as it allowed inspection of the wound without removing the dressing.