VENOUS LEG ULCERS - IS PAIN A PROBLEM

Objective: To employ standardized techniques to measure and characteri ze the pain associated with leg ulcers of defined causes. Methods: Pat ients attending leg ulcer clinics were interviewed by one research nur se using a structured questionnaire. Ulcers were classified as venous, arterial or mixed depending on the clinical assessment and ankle-brac hial systolic pressure index. Pain was assessed objectively using two validated instruments for scoring pain: a verbal rating scale and a pa in-intensity visual analogue scale. The significance of the observatio ns was tested using either the Mann-Whitney U-test (unpaired observati ons) or the Wilcoxon signed-rank test (paired observations). A profile of the quality of pain was obtained using the short-form McGill Pain Questionnaire (SF-MPQ). Quality of life was assessed using the COOP Ch art System. Patients: We assessed 38 patients with venous ulcers, thre e patients with mixed arterial/venous ulceration and 10 patients with arterial disease. Main outcome measures: Pain scores on verbal rating scales and visual analogue scales. Results: Venous leg ulcers are pain ful. Although pain scores are greater in arterial ulcers, most patient s with venous ulceration suffer at least moderate pain. Night pain dis turbed sleep in 73% of all patients and pain affected mood in more tha n 50%. Dressing changes exacerbated pain. Conclusions: Pain reduces th e quality of life in most patients with leg ulcers. Pain control is an essential consideration in all patients with leg ulcers.