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Management of Pressure Ulcers
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To the Editor: In his Contempo Updates article about pressure ulcers, Dr Lyder did not address the systematic evaluation of the presence of pressure ulcer pain.1 Pain may arise from many sources, including bacterial enzymes, tissue erosion, therapeutic maneuvers, and comorbid conditions, such as contractures, arterial insufficiency, and neuropathy.2
My colleagues and I previously reported that one third of patients with pressure ulcers were able to communicate their responses to pain either using the visual analogue scale or a FACES Pain Rating Scale.3 Two thirds of patients reported pain from pressure ulcers when the affected sites were not being manipulated, with intensity ranging from mild to "pain as bad as it can be" for the visual analogue scale or from "hurts a little bit" to "hurts worse" for the FACES Pain Rating Scale. We also found that the degree of pain was correlated with the stage of the pressure ulcer, . . . [Full Text of this Article]
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