{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T15:19:47Z","timestamp":1764775187407,"version":"3.46.0"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T00:00:00Z","timestamp":1764720000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Virtual Reality (VR) is an advanced technological system which, besides its use in entertainment and education, has been permanently introduced over the past quarter-century into physical and psychiatric rehabilitation as well as medicine. Its effectiveness has been demonstrated in pain management during medical and rehabilitation procedures in burn patients, alleviation of cancer pain, and reduction of labor pain. VR is increasingly used during routine medical procedures in children, such as blood sampling, intravenous cannulation, and vaccination, and holds promise for chronic pain management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The aim of this study was to assess pain during the treatment of hard-to-heal wounds of vascular origin using VR as an adjunct non-pharmacological pain therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>\n                      An observational study was conducted in a chronic wound care clinic involving 100 patients. The mean age was 68.02\u202f\u00b1\u202f10.0\u202fyears. All participants had hard-to-heal wounds of vascular origin. The mean wound duration was 7.16\u202f\u00b1\u202f5.08\u202fmonths, with an average wound area of 39.18\u202f\u00b1\u202f71.83\u202fcm\n                      <jats:sup>2<\/jats:sup>\n                      (range 2\u202fcm\n                      <jats:sup>2<\/jats:sup>\n                      to 625\u202fcm\n                      <jats:sup>2<\/jats:sup>\n                      ). Patients were randomly assigned to a group distracted with VR goggles and a control group receiving standard care without VR. Pain intensity was assessed using the Numeric Rating Scale (NRS) at three time points, and the McGill Pain Questionnaire (MPQ) before the procedure, during wound debridement, and 10\u202fmin after completion.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Statistically significant differences were observed in pain assessment before and during wound debridement (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05). In the VR group, higher pain scores were recorded before wound care compared to the control group. Ten minutes before wound debridement, the mean pain intensity in the VR group was 2.60\u202f\u00b1\u202f1.63, higher than 2.0\u202f\u00b1\u202f1.53 in the control group. During wound debridement, pain intensity was higher in the control group (4.94\u202f\u00b1\u202f1.53) compared to the VR group (4.32\u202f\u00b1\u202f2.17). Pain intensity 10\u202fmin after debridement was similar in both groups: control (2.24\u202f\u00b1\u202f1.41) and VR (2.36\u202f\u00b1\u202f1.71). These findings support the hypothesis that VR goggles reduce pain intensity. No statistically significant differences in NRS pain scores were found between patients with different wound types in either group (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;gt;\u202f0.05). Variables such as wound duration and wound size influenced pain levels 10\u202fmin before wound care. No association was found between sex and pain intensity (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;gt;\u202f0.005).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Increased pain during procedures involving manipulation of damaged tissues and wound debridement is a common phenomenon. This study confirmed that the use of VR goggles reduces perceived pain levels. The assessment of pain experience and intensity varies depending on the assessment tools used; therefore, a combined quantitative and qualitative evaluation is recommended to accurately determine the usefulness of innovative tools in clinical practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2025.1658190","type":"journal-article","created":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T15:16:48Z","timestamp":1764775008000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Monitoring pain during use of virtual reality in debridement procedures of vascular wounds in outpatient care settings"],"prefix":"10.3389","volume":"12","author":[{"given":"Joanna","family":"Przybek-Mita","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dariusz","family":"Bazali\u0144ski","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Surmacz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Ko\u0142odziej","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julia","family":"Bry\u0142a","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,12,3]]},"reference":[{"key":"ref1","first-page":"691","article-title":"A rapid evidence assessment of immersive virtual reality as an adjunct therapy in acute pain management in clinical practice","volume":"34","author":"Garrett","year":"2018","journal-title":"Clin J Pain"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"100741","DOI":"10.1016\/j.hlpt.2023.100741","article-title":"What is virtual reality? A healthcare-focused systematic review of definitions","volume":"12","author":"Abbas","year":"2023","journal-title":"Health Policy Technol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"5","DOI":"10.12968\/jowc.2013.22.Sup1.S1","article-title":"EWMA document: debridement. An updated overview and clarification of the principle role of debridement","volume":"22","author":"Strohal","year":"2013","journal-title":"J Wound Care"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1097\/01.ASW.0000733724.87630.d6","article-title":"Wound bed preparation 2021","volume":"34","author":"Sibbald","year":"2021","journal-title":"Adv Skin Wound Care"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"136","DOI":"10.1016\/j.jtv.2022.11.002","article-title":"Wound irrigation versus swabbing technique for cleansing noninfected chronic wounds: a systematic review of differences in bleeding, pain, infection, exudate, and necrotic tissue","volume":"32","author":"Rajhathy","year":"2023","journal-title":"J Tissue Viability"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"84","DOI":"10.5114\/lr.2022.120199","article-title":"Debridement of hard-to-heel wounds provided in the home-care setting. Practical and legal possibilities","volume":"19","author":"Sk\u00f3rka","year":"2022","journal-title":"Lecz Ran"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"S1","DOI":"10.12968\/jowc.2019.28.Sup3a.S1","article-title":"Implementing TIMERS: the race against hard-to-heal wounds","volume":"23","author":"Atkin","year":"2019","journal-title":"J Wound Care"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"S1","DOI":"10.12968\/jowc.2020.29.Sup3b.S1","article-title":"International consensus document. Defying hard-to-heal wounds with an early antibiofilm intervention strategy: wound hygiene","volume":"29","author":"Murphy","year":"2020","journal-title":"J Wound Care"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"288","DOI":"10.1016\/j.jval.2021.04.1285","article-title":"Using virtual reality exposure therapy in pain management: a systematic review and Meta-analysis of randomized controlled trials","volume":"25","author":"Huang","year":"2022","journal-title":"Value Health"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"4229","DOI":"10.3390\/jcm14124229","article-title":"The use of virtual reality as a non-pharmacological approach for pain reduction during the debridement and dressing of hard-to-heal wounds","volume":"14","author":"Bazali\u0144ski","year":"2025","journal-title":"J Clin Med"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"2053","DOI":"10.2147\/JPR.S200498","article-title":"Virtual reality as an analgesic for acute and chronic pain in adults: a systematic review and meta-analysis","volume":"12","author":"Mallari","year":"2019","journal-title":"J Pain Res"},{"key":"ref12","first-page":"e9","article-title":"Virtual reality for management of pain in hospitalized patients: results of a controlled trial","volume":"5","author":"Tashjian","year":"2018","journal-title":"JMIR Ment Health"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"858","DOI":"10.1097\/AJP.0000000000000599","article-title":"Virtual reality as a distraction intervention to relieve pain and distress during medical procedures: a comprehensive literature review","volume":"34","author":"Indovina","year":"2018","journal-title":"Clin J Pain"},{"key":"ref14","first-page":"4194","article-title":"Using narrative inquiry and ethnography to understand the impact of VR distraction for pain management in the home setting","volume":"29","author":"Chan","year":"2020","journal-title":"J Clin Nurs"},{"key":"ref15","year":"2024"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1016\/0304-3959(75)90044-5","article-title":"The mcgill pain questionnaire: major properties scoring methods","volume":"1","author":"Melzack","year":"1975","journal-title":"Pain"},{"key":"ref17","first-page":"10","article-title":"The McGill pain questionnaire (MPQ) and the shortened version of the McGill pain questionnaire","volume":"14","author":"Ko\u0142\u0142\u0105taj","year":"2013","journal-title":"B\u00f3l [Pain]"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"1976","DOI":"10.1097\/j.pain.0000000000001939","article-title":"The revised International Association for the Study of Pain definition of pain: concepts, challenges, and compromises","volume":"161","author":"Raja","year":"2020","journal-title":"Pain"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"102480","DOI":"10.1016\/j.ctim.2020.102480","article-title":"Virtual reality in psychiatric disorders: a systematic review of reviews","volume":"52","author":"Cie\u015blik","year":"2020","journal-title":"Complement Ther Med"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1097\/PHM.0000000000000417","article-title":"Effects of virtual walking treatment on spinal cord injury-related neuropathic pain: pilot results and trends related to location of pain and at-level neuronal hypersensitivity","volume":"95","author":"Jordan","year":"2016","journal-title":"Am J Phys Med Rehabil"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"111816","DOI":"10.1016\/j.jclinane.2025.111816","article-title":"Virtual reality improves pain threshold and recall in healthy adults: a randomized, crossover study","volume":"103","author":"Rodriguez","year":"2025","journal-title":"J Clin Anesth"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"971","DOI":"10.1126\/science.150.3699.971","article-title":"Pain mechanisms: a new theory","volume":"150","author":"Melzack","year":"1965","journal-title":"Science"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"516","DOI":"10.1037\/0033-2909.95.3.516","article-title":"Distraction and coping with pain","volume":"95","author":"McCaul","year":"1984","journal-title":"Psychol Bull"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"449","DOI":"10.1518\/001872008X288394","article-title":"Multiple resources and mental workload","volume":"50","author":"Wickens","year":"2008","journal-title":"Hum Factors"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"2235","DOI":"10.1093\/pm\/pnab110","article-title":"Associations of pain numeric rating scale scores collected during usual care with research administered patient reported pain outcomes","volume":"22","author":"Nugent","year":"2021","journal-title":"Pain Med"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/1471-2431-5-1","article-title":"The efficacy of playing a virtual reality game in modulating pain for children with acute burn injuries: a randomized controlled trial","volume":"5","author":"Das","year":"2025","journal-title":"BMC Pediatr"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"299","DOI":"10.1097\/AJP.0b013e318164d2cc","article-title":"Virtual reality pain control during burn wound debridement in the hydrotank","volume":"24","author":"Hoffman","year":"2008","journal-title":"Clin J Pain"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"244","DOI":"10.1097\/00002508-200009000-00010","article-title":"Use of virtual reality for adjunctive treatment of adult burn pain during physical therapy","volume":"16","author":"Hoffman","year":"2000","journal-title":"Clin J Pain"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1097\/00002508-200109000-00007","article-title":"Effectiveness of virtual reality-based pain control with multiple treatments","volume":"17","author":"Hoffman","year":"2001","journal-title":"Clin J Pain"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"S43","DOI":"10.1016\/j.apmr.2007.09.004","article-title":"Factors influencing the efficacy of virtual reality distraction analgesia during postburn physical therapy: preliminary results from 3 ongoing studies","volume":"88","author":"Sharara","year":"2007","journal-title":"Arch Phys Med Rehabil"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"785","DOI":"10.1097\/BCR.0b013e3181b485d3","article-title":"The effect of virtual reality on pain and range of motion in adults with burn injuries","volume":"30","author":"Carrougher","year":"2009","journal-title":"J Burn Care Res"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"834","DOI":"10.1037\/0021-843X.115.4.834","article-title":"Analgesic effects of posthypnotic suggestions and virtual reality distraction on thermal 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