{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T23:53:02Z","timestamp":1773273182732,"version":"3.50.1"},"reference-count":22,"publisher":"Mark Allen Group","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Wound Care"],"published-print":{"date-parts":[[2005,6]]},"abstract":"<jats:sec><jats:title>Objective:<\/jats:title><jats:p>To assess the efficacy of the topical application of morphine on painful chronic skin ulcers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method:<\/jats:title><jats:p>A prospective bi-centric controlled double-blind randomised study was conducted involving 24 patients with painful chronic skin ulcers using topically applied morphine versus placebo. Ten milligrams of morphine hydrochloride with Intrasite Gel or Intrasite Gel with placebo were applied daily for five days. All patients were treated with a level II analgesic treatment. A numeric pain scale lower than 4\/10 and no need for a \u2018rescue\u2019 treatment (morphine sulphate) indicated that the treatment was successful. Local and systemic tolerance of the treatments was analysed daily.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p>Twenty-four patients were included in the study, but only 18 started the protocol. Only 2\/11 patients were completely relieved in the morphine group compared with 1\/7 in the placebo group. Local and general tolerance of morphine was good. The peripheral efficacy of morphine is under discussion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion:<\/jats:title><jats:p>The results suggest that topical morphine cannot be an alternative to morphine administered by other routes (subcutaneously or orally) in painful chronic skin ulcers. Stimulation of peripheral morphine receptors by systemic morphine could explain the difference between these results and those of previous studies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Declaration of interest:<\/jats:title><jats:p>This study was supported by the University Hospital of Nancy and the Association Lorraine d\u2019Etude et de Recherche en Dermatologie, France.<\/jats:p><\/jats:sec>","DOI":"10.12968\/jowc.2005.14.6.26793","type":"journal-article","created":{"date-parts":[[2014,5,23]],"date-time":"2014-05-23T16:00:35Z","timestamp":1400860835000},"page":"289-293","source":"Crossref","is-referenced-by-count":28,"title":["Study to determine the efficacy of topical morphine on painful chronic skin ulcers"],"prefix":"10.12968","volume":"14","author":[{"given":"C.","family":"Vernassiere","sequence":"first","affiliation":[{"name":"Department of Dermatology, Fournier Hospital, Nancy, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Cornet","sequence":"additional","affiliation":[{"name":"University Hospital, Nancy, France."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P.","family":"Trechot","sequence":"additional","affiliation":[{"name":"University Hospital, Nancy, France."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F.","family":"Alla","sequence":"additional","affiliation":[{"name":"University Hospital, Nancy, France."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F.","family":"Truchetet","sequence":"additional","affiliation":[{"name":"Beauregard Hospital, Thionville, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.F.","family":"Cuny","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Fournier Hospital, Nancy, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N.","family":"Commun","sequence":"additional","affiliation":[{"name":"University Hospital, Nancy, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F.","family":"Granel Brocard","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Fournier Hospital, Nancy, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Barbaud","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Fournier Hospital, Nancy, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.L.","family":"Schmutz","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Fournier Hospital, Nancy, France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"5130","reference":[{"key":"p_1","volume-title":"Cancer Pain Relief: with a guide to opioid availability","author":"World Health Organization","year":"1996","edition":"2"},{"key":"p_3","doi-asserted-by":"publisher","DOI":"10.1016\/0885-3924(95)00101-4"},{"key":"p_4","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3959(98)00211-5"},{"key":"p_5","doi-asserted-by":"publisher","DOI":"10.1016\/S0885-3924(98)00140-7"},{"key":"p_6","doi-asserted-by":"publisher","DOI":"10.1177\/026921639701100412"},{"key":"p_8","doi-asserted-by":"publisher","DOI":"10.1016\/S0885-3924(00)00219-0"},{"key":"p_9","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V99.3.1096"},{"key":"p_10","doi-asserted-by":"publisher","DOI":"10.1016\/S0885-3924(03)00140-4"},{"key":"p_12","doi-asserted-by":"publisher","DOI":"10.1016\/S0885-3924(03)00146-5"},{"key":"p_14","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2125.1994.tb04306.x"},{"key":"p_16","doi-asserted-by":"crossref","unstructured":"significance. Anesth Analg 1993; 77: 5, 1041-1047.","DOI":"10.1213\/00000539-199311000-00029"},{"key":"p_18","first-page":"102","volume":"86","author":"The","year":"1998","journal-title":"Anesth Analg"},{"key":"p_19","first-page":"131","volume":"126","author":"Reichert-Penetrat S.","year":"1999","journal-title":"Ann Dermatol Venereol"},{"key":"p_21","doi-asserted-by":"crossref","first-page":"1269","DOI":"10.1016\/S0022-3565(25)24151-9","volume":"248","author":"Peripheral","year":"1989","journal-title":"J Pharmacol Exp Therap"},{"key":"p_24","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3959(90)91112-V"},{"key":"p_25","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199110173251602"},{"key":"p_26","doi-asserted-by":"publisher","DOI":"10.1213\/00000539-199301000-00031"},{"key":"p_27","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3959(97)03344-7"},{"key":"p_28","unstructured":"Some authors have suggested that topically administered morphine has a peripheral analgesic action, mainly in chronic inflammatory tissues,14-17although other studies contradict these results.18-19Unfortunately, the results of trials of acute pain are not applicable to chronic pain trials."},{"key":"p_29","unstructured":"Previous reports concerning the analgesic effect of morphine and diamorphine in painful chronic skin ulcers2-7used various protocols: 10mg of diamorphine with Intrasite Gel;2morphine gel;3-5oxycodone mixed with water;7and diamorphine mixed with a metronidazole gel.6Among these published cases, 12 patients were completely relieved, nine had partial relief and only one patient gained no relief with topical morphine or diamorphine. The analgesic effect began 20-30 minutes after application of morphine, with maximum relief at the seventh hour, after which it gradually decreased."},{"key":"p_53","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3959(97)00040-7"},{"key":"p_54","doi-asserted-by":"publisher","DOI":"10.1016\/S0885-3924(01)00251-2"}],"container-title":["Journal of Wound Care"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.magonlinelibrary.com\/doi\/pdf\/10.12968\/jowc.2005.14.6.26793","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,3]],"date-time":"2025-05-03T02:09:29Z","timestamp":1746238169000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.magonlinelibrary.com\/doi\/10.12968\/jowc.2005.14.6.26793"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2005,6]]},"references-count":22,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2005,6]]}},"alternative-id":["10.12968\/jowc.2005.14.6.26793"],"URL":"https:\/\/doi.org\/10.12968\/jowc.2005.14.6.26793","relation":{},"ISSN":["0969-0700","2052-2916"],"issn-type":[{"value":"0969-0700","type":"print"},{"value":"2052-2916","type":"electronic"}],"subject":[],"published":{"date-parts":[[2005,6]]}}}