Virtual Reality for Pain Relief During Burn Dressing Changes

Burn wound dressing changes can be painful, repetitive, and emotionally demanding. Even when medicines are used appropriately, patients may experience anticipatory anxiety, distress, and a heightened response to touch as dressings are removed, wounds are cleaned, and new coverings are applied.

A pilot study of virtual reality for pain management during burn wound dressing changes can test whether an immersive digital experience is a practical addition to established care. Rather than replacing analgesics or skilled clinical support, virtual reality (VR) may provide a second channel for reducing attention to procedural pain and helping patients feel more in control.

For a health translation partnership, the value of such a study extends beyond whether pain scores fall. Researchers and clinicians also need to understand which patients can use the technology, when it should be offered, how staff can deliver it safely, and whether the approach fits the realities of a busy burns service.

Why Dressing Changes Require More Than Medication

Procedural pain is influenced by tissue damage, inflammation, previous experiences, anxiety, sleep, age, and the length of treatment. A patient who expects severe pain may become tense before a dressing change begins, which can increase distress and make physical sensations feel more intense.

Pharmacological analgesia remains central to burn care, but it may not address every part of the experience. Some medicines cause drowsiness, nausea, or reduced alertness, while their effect may not match the timing of a procedure. Non-drug approaches such as breathing exercises, guided imagery, music, conversation, and distraction can be used alongside medication.

VR offers an immersive form of distraction. A headset can place the user in a calm virtual environment, an interactive game, or a guided sensory experience. By directing visual and auditory attention elsewhere, it may reduce the mental bandwidth available for processing unpleasant sensations during wound care.

Building a Practical Pilot Design

A small feasibility study should begin with a clear clinical question. For example, investigators might examine whether VR can reduce patient-reported pain and distress during dressing changes compared with usual care, while also recording how often the device can be used successfully.

Participants could include adults or adolescents receiving repeated dressing care, provided the inclusion criteria reflect the device’s safety requirements. A crossover design may allow each participant to experience usual care and usual care combined with VR on separate occasions. This can help account for differences in wound severity and individual pain sensitivity.

The intervention should be standardised without becoming rigid. The study team can define when VR begins, how long it is offered, which content is available, and when it must be stopped. Clinicians should retain authority to pause the session if a patient needs communication, medication, wound assessment, or urgent clinical attention.

Measuring Pain, Distress, and Feasibility

Pain intensity may be recorded before, during, and after the dressing change using a validated numerical or visual rating scale. Distress, anxiety, perceived control, and satisfaction can add important context. A lower pain score is useful, but a patient who feels calmer and more able to participate may also have gained a meaningful benefit.

Feasibility outcomes should be treated as primary evidence in a pilot. These may include recruitment and completion rates, headset tolerance, technical failures, staff time, cleaning procedures, and the proportion of dressing changes in which VR was used for the planned duration. Reasons for declining or stopping the intervention should be documented rather than treated as missing information.

Safety monitoring is essential. Researchers should record dizziness, nausea, headache, visual discomfort, disorientation, skin or equipment issues, and any interruption to clinical care. Content should be appropriate for the patient’s age, culture, cognitive capacity, and emotional state, with a non-immersive alternative available when a headset is unsuitable.

Interpreting Results Without Overclaiming

A pilot study is usually designed to assess feasibility and refine a future trial, not to prove definitive clinical effectiveness. A promising reduction in pain should therefore be interpreted alongside sample size, missing data, variation between participants, and the timing of analgesic administration.

The research team should also examine whether benefits differ across groups. Younger patients may engage readily with interactive content, while some adults may prefer calming landscapes or guided relaxation. People with visual impairment, cognitive changes, trauma-related symptoms, or motion sensitivity may require alternative formats.

Repeated use could produce different results from a single session. Some patients may become familiar with the technology and use it more effectively over time. Others may lose interest, find the content repetitive, or experience discomfort after prolonged exposure. These patterns can guide the design of a larger comparative study.

Co-Designing Care With Patients and Families

Patient and public involvement can improve the intervention before recruitment begins. Patients who have experienced burns can identify practical concerns that researchers may overlook, including headset pressure, privacy, fear of missing instructions, infection-control expectations, and the need to stop quickly when pain escalates.

Trust is especially important when research takes place during a vulnerable clinical experience. Clear explanations should describe what VR can and cannot do, how usual pain relief will continue, and how personal information will be managed. Resources on community trust in research can support a transparent and respectful engagement approach.

Families and carers may also contribute to acceptability, particularly for children or patients who need help selecting content. Their involvement should complement, rather than override, the patient’s preferences. Consent must remain informed and voluntary, with no suggestion that declining VR will affect access to care.

Moving From Evidence to Clinical Practice

If the pilot indicates that VR is acceptable, safe, and potentially beneficial, the next step may be a larger controlled trial across several burns services. That study could assess clinically meaningful pain reduction, changes in opioid or sedative requirements, recovery experience, and cost-effectiveness.

Implementation planning should begin early. A service will need infection-control protocols, charging and storage arrangements, content licensing, staff training, technical support, and procedures for documenting use in the clinical record. These operational details can determine whether an intervention remains available after a research project ends.

A translation-focused partnership can connect investigators with burns clinicians, digital health specialists, consumers, health services, and decision-makers. The Brisbane Diamantina network provides a relevant setting for linking research evidence with clinical innovation, education, governance, and health-service priorities.

Priorities for a Patient-Centred Study

A strong protocol should keep the patient experience at its centre while producing evidence that clinicians can use. The following priorities can help investigators balance scientific rigour with practical delivery:

• Use VR as an adjunct to prescribed analgesia, psychological support, and skilled wound care.
• Measure pain, distress, anxiety, satisfaction, and perceived control at clinically relevant time points.
• Include feasibility and safety outcomes, including device tolerance, cleaning, interruptions, and staff workload.
• Offer content choices and non-headset alternatives for patients who cannot or do not wish to use immersive technology.
• Involve patients, families, carers, and frontline staff in selecting content and designing the delivery process.

The most valuable result may be a clear understanding of where VR fits in the care pathway. If immersive distraction helps some patients feel safer and more prepared during dressing changes, a carefully designed pilot can provide the evidence needed to test, adapt, and responsibly scale the approach across burn services. Further collaboration between researchers, consumers, and health providers can turn that evidence into more compassionate procedural care.