Analgesic Effects of Using Ringer's Solution in Wound Healing Management
Pain resulting from skin defects of various etiologies causes significant discomfort for the patient. However, wound care using Ringer's solution and the use of primary dressings, which include this solution to maintain a constant moist environment in the wound, can help address this problem.
Ringer's Solution and Its Use in Wound Healing
Ringer's solution is an isotonic electrolyte solution referred to as R1/1. It contains sodium, potassium, and calcium chlorides in concentrations corresponding to blood plasma. It is primarily indicated for short-term fluid replacement in isotonic dehydration and for restoring ionic balance. Due to its physiological composition, it is also used externally in wound treatment − for rinsing and as part of dressings in moist healing.
Clinical studies suggest that treating wounds with dressings containing an isotonic solution may provide relief from persistent pain, mainly due to its ability to maintain a moist wound environment continuously. One of the functions of the dressing is to protect the wound from unwanted friction. The solution enhances the protective barrier function by constantly keeping the liquid between the primary and secondary dressing, covering the nerve endings of the defect and eliminating friction.
A moist environment is essential for the healing process and subsequently supports the production of new tissue. Due to these processes, the wound consistently maintains an ideal temperature for healing. A moist wound environment can ensure the efficient recruitment of leukocytes, which fulfill their role in phagocytosis and release natural substances that reduce the sensation of pain.
Ringer's solution also affects the production of exudate and its pH. Exudate contains large amounts of pro-inflammatory cytokines, whose high levels in the wound prevent healing. The use of dressings with Ringer's solution dilutes them. The presence of the solution in the wound dressing also reduces the concentration of matrix metalloproteinases (MMP) that break down extracellular matrix proteins. The pH change of the wound bed further affects the function of proteins and glycoproteins involved in the pain response, such as sodium and calcium channels.
Summary of Clinical Study Findings
403 patients suffering from chronic wounds participated in a multicenter observational study, during which they received dressings containing Ringer's solution for an average of 1 month. At the beginning of the study, 65% of participants reported moderate to severe pain, which decreased to 13% by the end of the treatment. Patients reported low pain during dressing changes, with 89% rating the dressing change regarding pain as “good” or “very good”.
Another multicenter study involved 170 patients suffering from chronic wounds for an average of 5 months. They were subsequently treated with dressings containing Ringer's solution and observed for 8 days. Before observation, 35% experienced moderate to severe pain, which dropped to 19% by the end.
A prospective open study evaluated therapy with Ringer's solution dressings in 221 patients with various etiologies of chronic wounds over 1 month. The incidence of moderate to severe pain during the observation decreased from the original 64% to 19%.
Additionally, numerous case studies report promising results using dressings containing Ringer's solution. For example, a 74-year-old patient dealing with chronic venous ulceration reported significant pain relief after applying dressings with Ringer's solution. In the case of an 82-year-old patient with a laceration due to trauma, analgesic effects were observed after applying moist environment-providing dressings.
Conclusion
The findings from clinical research highlight the benefits of using Ringer's solution, which shows analgesic effects and supports the healing process by maintaining an appropriate moist wound environment. This type of primary dressing also provides protection to the nerve endings in the wound, helps eliminate exudate, and supports leukocyte production.
Patients reported low pain levels in clinical studies of wound dressings with Ringer's solution. To gain a clearer understanding of the mechanisms and effectiveness of this product's analgesic action, further extensive clinical studies and direct comparisons with other types of wound dressings are needed.
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Source: Colegrave M., Rippon M. G., Richardson C. The effect of Ringer's solution within a dressing to elicit pain relief. J Wound Care 2016; 25 (4): 184−190, doi: 10.12968/jowc.2016.25.4.184.
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