Reduced pain is a symptom of healing in patients with chronic wounds, suggesting that molecular mechanisms involved in opioid pain treatments may play a role in wound healing. Pain control can also facilitate wound care procedures. However, reduced immune activity that sometimes accompanies opioid treatment may have negative repercussions on wound healing. Clinical and wound outcome data were analyzed from the WE-HEAL study, which follows patients with chronic wounds over time. Although there were equivalent numbers of chronic wounds that finally healed or didn’t heal whether the patients did or did not receive opioid pain medicine, the time to healing was significantly more rapid for those who had never received opioids. Patients receiving higher opioid doses due to larger wound size or painful comorbidities such as lymphedema or sickle cell disease had slower wound healing in comparison with those receiving lower doses or no opioids. These findings raise important considerations in clinical management of chronic wounds.
Shanmugam VK, Couch KS, McNish S, Amdur RL. Relationship between opioid treatment and rate of healing in chronic wounds. Wound Repair Regen. 2017 Jan;25(1):120-130. PMID: 27865036