Can Wound Exudate from Venous Leg Ulcers Measure Wound Pain Status?: A Pilot Study

Abstract

We investigated the associations between the self-evaluated pain status and two pain biomarker candidates, nerve growth factor and S100A8/A9, in exudate from venous leg ulcer to finally develop an objective pain evaluation method. Patients with venous leg ulcer participated in this cross-sectional observational study conducted between April and October 2014 at two medical facilities. During routine wound care, each participant self-evaluated their pain status at each examination using the 10-point numerical rating scale (present pain intensity) and the short-form McGill Pain Questionnaire 2 (continuous pain, intermittent pain, neuropathic pain, affective descriptors, and total score). Venous leg ulcer exudate sample was collected after wound cleansing. The nerve growth factor and S100A8/A9 concentrations in the venous leg ulcer exudate were measured by enzyme-linked immunosorbent assay and standardized according to the wound area. The association between each pain status and the two standardized protein concentrations was evaluated using Spearman’s correlation coefficient. In 30 sample collected from 13 participants, the standardized nerve growth factor concentration was negatively correlated with continuous pain (ρ = -0.47, P = 0.01), intermittent pain (ρ = -0.48, P = 0.01), neuropathic pain (ρ = -0.51, P = 0.01), and total score (ρ = -0.46, P = 0.01). The standardized S100A8/A9 concentration was positively correlated with present pain intensity (ρ = 0.46, P = 0.03) and continuous pain (ρ = 0.48, P = 0.03). Thus, these two proteins may be useful for objective evaluation of wound pain in venous leg ulcer patients.

Wound fluid sampling methods for proteomic studies: A scoping review

“…Vacuum, drainage, or other external devices were used in 124 of the 280 (44%) studies and thus were the most frequently used methods of sample collection 22–27,29–146 ; the vast majority of sample collections using this method (75%, 103/138), were from surgical wounds (Figure 2B). Three other frequently used methods were extraction from absorbent material (31%, 86/280),…”

Longitudinal peripheral tissue RNA‐Seq transcriptomic profiling, hyperalgesia, and wound healing in the rat plantar surgical incision model

“…The evolving temporal stages of wound healing reflect different biological mechanisms comprising multiple molecular and intercellular communication networks. For example, pro‐inflammatory cytokines, growth factors, and various hormones have been associated with wound pain, which have also informed the wound‐healing progress 6,7 . However, a variety of factors, including the environment and stress, which are sometimes uncontrollable, can affect wound status 8,9 .…”

“…For example, pro‐inflammatory cytokines, growth factors, and various hormones have been associated with wound pain, which have also informed the wound‐healing progress. 6 , 7 However, a variety of factors, including the environment and stress, which are sometimes uncontrollable, can affect wound status. 8 , 9 These complexities make understanding the full biological dynamics of wounds challenging, and make predicting which path a wound will take, to healing or chronification, difficult to determine.…”

Chronic Pain Treatment for Patients with Vascular Ulcers of the Lower Limbs

“…Opioids with high affinity for MOP receptors, such as Morphine, Fentanyl and Oxycodone, are more responsible for side effects such as itchiness, constipation, sleepiness, nausea or vomit. [8,9] Morphine derivatives raise susceptibility to infections, accelerate infection progression and increase one's mortality risk. Experimental studies demonstrated that opioids lower neutrophil recruitment to the infected area in vitro.…”