Over my 35 years of clinical experience treating patients with chronic illnesses, I’ve come to recognise a crucial truth: the burden of chronic symptoms persists, regardless of how “well-managed” a disease may appear on paper. For patients with conditions such as chronic venous leg ulcers (CVLUs), pain is a serious and clinically unaddressed issue. CVLUs are one of the most common lower extremity wounds, affecting over over 1% of the adult population globally and a recurrence rate that can be as high as 75% within just three weeks of healing [1]. Pain flares with dressing changes, worsens at night, and is compounded by pressure and infection. Swelling, malodour, redness, and itching add to the torment. It’s a complex, persistent pain that is rarely fully appreciated—and even more rarely, well managed. It steals sleep, mobility, dignity, and independence. For older patients, even the simple acts of walking, shopping, or planning a day become insurmountable, and many suffer in silence. Unmanaged pain undermines everything: from a patients’ ability to manage co-existing conditions such as diabetes and hypertension, to their mental health, autonomy and quality of life.

From a clinical perspective, CVLU-related pain remains severely overlooked, while other chronic pain conditions, such as cancer or arthritis, are treated with analgesia as a priority. Worse still, many of the most effective treatments used to debride chronic wounds, including surgical debridement (which risks cutting into living tissue) and certain topical therapies (where patients must be anaesthetised due to extreme pain), further exacerbate the suffering that patients must endure. However, I firmly believe that for wounds to be effectively debrided, patients should not have to experience additional, perhaps avoidable, pain.

In my seven years of dedicated wound care experience, I’ve seen how incredibly urgent the need is for wound treatments that are not only safe and effective, but also pain-free. And at SolasCure, this is precisely our mission: to develop a gentle yet effective therapy that not only treats the wound to help it heal, but also provides patient comfort. In our recent publication in the International Wound Journal [2], we assess pain levels associated with tarumase gel during VLU debridement, comparing them to those reported for traditional surgical and mechanical methods. We believe two aspects of this innovation are critical. First, the rapid reduction of wound bioburden—pain, infection, inflammation—can immediately improve patient comfort. Second, facilitating faster healing and at-home treatment reduces the need for exhausting clinic visits, particularly for frail, multi-morbid patients. For many, this shift could transform a life of hardship into one of renewed possibility.

The NHS is beginning to explore more robust home-based care models which are already growing exponentially in countries like the US since COVID. But clinicians on the frontlines of wound care already know what’s needed: highly effective, easy-to-use, and truly patient-centred solutions that honour the full spectrum of human suffering.

The pain of chronic wounds is not just a clinical detail - it is a lived experience that shapes every moment of a patient’s life. We owe it to them to do better, and to finally address the pain they’ve long endured in silence.

Author: Dr David J.A. Goldsmith, MA(Cantab) MB BChir FRCP(UK) FFPM, Senior Medical Advisor

Dr. David Goldsmith has served as SolasCure’s Senior Medical Advisor since 2023, and was previously Chief Medical Officer. He is a highly experienced clinician and pharmaceutical physician with over 30 years of clinical experience in nephrology and 7 years leading drug and device development for biopharmaceutical start-ups. He has extensive experience in clinical trials, over 500 publications, and has raised significant research funding. He also holds expertise in wound care, AI, and machine learning.

References

1. Probst, S., Weller, C.D., Bobbink, P. et al. Prevalence and incidence of venous leg ulcers—a protocol for a systematic review. Syst Rev 10, 148 (2021). https://doi.org/10.1186/s13643-021-01697-3

2. Goldsmith, D., & Fairlamb, D. M. (2025). The Potential Role for a Painless Enzymatic Debridement Gel in Wound Bed Preparation for Venous Leg Ulcers-A Dose Escalation Study. International wound journal, 22(6), e70702. https://doi.org/10.1111/iwj.70702