chronic wounds, wound healing and itch, itch phenomenon



  1. Paul, Julia PhD, RN, ACNS-BC, CCRN, CWS, NP


PURPOSE: To enhance the learner's competence with knowledge of characteristics of chronic wounds that itch.


TARGET AUDIENCE: This continuing education activity is intended for physicians and nurses with an interest in skin and wound care.


OBJECTIVES: After participating in this educational activity, the participant should be better able to:


1. Summarize information about the physiology of wound itch and problems caused by scratching wounds.


2. Interpret the design and results of the study presented.


3. Predict which wounds are associated with increased wound itch.


ABSTRACT: OBJECTIVE: This study was designed to explore characteristics of chronic wounds that present with wound-related itch.


BACKGROUND: Although wound-related itch is recognized clinically, little is known about the phenomenon. Recent scientific advances have enabled the study of itch physiology, yet the clinical problem is not well described in the literature.


DESIGN: The study was observational, descriptive.


METHOD: Persons (N = 200) with wounds being followed up at a hospital-affiliated wound care center were interviewed and assessed. Instruments included a health history tool, Paul-Pieper Itching Questionnaire, Bates-Jensen Wound Assessment Tool, and 10-g monofilament for assessment of sensation in the area of the wound.


RESULTS: Participants were aged 21 to 98 years (mean, 66.82 [SD, 14.02] years); 56% of the participants were men, and 85% were white. One-fourth (56/200) of the participants reported wound-related itch. Wounds that itched were generally larger (t77.74 = -3.27; P = .002; d = 0.63; 95% confidence interval [CI], -1.01 to -0.25), had more tissue edema (t88.38 = -2.19; P = .031; 95% CI, -0.93 to -0.47), and demonstrated more granulation tissue in the wound base (t98.71 = 2.03; P = .045; 95% CI, 0.01-0.87), compared with wounds without itch. Greater itch was associated with wounds that had a moderate amount of exudate (P = .02) or necrotic tissue in the base.


CONCLUSIONS: Wound itch was present in more severe wounds as evidenced by larger size, more tissue edema, and necrotic tissue. Understanding wound itch could promote wound healing and improve quality of life for persons with chronic wounds.