The DOI matches its Crossref record; 33 of the 36 references it cites were found in a registry or an index.
Virtual reality as an adjunctive pain control during burn wound care in adolescent patients
Abstract
For daily burn wound care procedures, opioid analgesics alone are often inadequate. Since most burn patients experience severe to excruciating pain during wound care, analgesics that can be used in addition to opioids are needed. This case report provides the first evidence that entering an immersive virtual environment can serve as a powerful adjunctive, nonpharmacologic analgesic. Two patients received virtual reality (VR) to distract them from high levels of pain during wound care. The first was a 16-year-old male with a deep flash burn on his right leg requiring surgery and staple placement. On two occasions, the patient spent some of his wound care in VR, and some playing a video game. On a 100 mm scale, he provided sensory and affective pain ratings, anxiety and subjective estimates of time spent thinking about his pain during the procedure. For the first session of wound care, these scores decreased 80 mm, 80 mm, 58 mm, and 93 mm, respectively, during VR treatment compared with the video game control condition. For the second session involving staple removal, scores also decreased. The second patient was a 17-year-old male with 33.5% total body surface area deep flash burns on his face, neck, back, arms, hands and legs. He had difficulty tolerating wound care pain with traditional opioids alone and showed dramatic drops in pain ratings during VR compared to the video game (e.g. a 47 mm drop in pain intensity during wound care). We contend that VR is a uniquely attention-capturing medium capable of maximizing the amount of attention drawn away from the 'real world', allowing patients to tolerate painful procedures. These preliminary results suggest that immersive VR merits more attention as a potentially viable form of treatment for acute pain.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“VR is so attention grabbing that it is being used to distract severe burn patients from their pain during severe burn wound cleaning, and burn patients report large reductions in the amount of time they spend thinking about their pain during painful medical procedures [22–25].”
Citations
Cites
(1963) · Medical Entomology and Zoology · Cited by 15,085
Pain mechanisms: a new theory.
Melzack, R., & Wall, P. D. (1965) · Science · doi:10.1126/science.150.3699.971 · Cited by 11,108
Shiffrin, R. M., & Schneider, W. (1977) · Psychological Review · doi:10.1037/0033-295x.84.2.127 · Cited by 7,335
Egeth, H. E., & Kahneman, D. J. (1975) · The American Journal of Psychology · doi:10.2307/1421603 · Cited by 6,976
Controlled and automatic human information processing: I. Detection, search, and attention.
Schneider, W., & Shiffrin, R. M. (1977) · Psychological Review · doi:10.1037/0033-295x.84.1.1 · Cited by 5,902
HUSKISSON, E. C. (1974) · The Lancet · doi:10.1016/s0140-6736(74)90884-8 · Cited by 4,533
Melzack, R., & Wall, P. D. (1996) · Pain Forum · doi:10.1016/s1082-3174(96)80062-6 · Cited by 2,786
Controlled and automatic human information processing: I
Schneider, W. E., & Shiffrin, R. M. (1977) · Cited by 2,228
Rheingold, H. (1991) · Cited by 1,804
Gift, A. G. (1989) · Nursing Research · doi:10.1097/00006199-198909000-00006 · Cited by 1,223
Research works printed but not linked: 4
- Cooper, 1990, Altered pharmacology in thermal injury., Crit Care Rep, 2, 78
- Everett, 1990, Cognitive and behavioural treatments for burn pain., Pain Clinic, 3, 1133
- Kennedy, 1992, Presence: teleoperators and virtual, environments, 1, 295
- Perry, 1981, Assessment of pain by burn patients., J Burn Care Rehabil, 2, 322, 10.1097/00004630-198111000-00004 · DOI
Cited by
Sorted by citations
Items 601–651 of 651
Virtual Reality: A Game Changer for Children’s Medical Procedures
Mounsef, P. J., Addab, S., Hamdy, R. C., May, S. L., Thorstad, K., & Tsimicalis, A. (2024) · Frontiers for Young Minds · doi:10.3389/frym.2024.1376603
Effect of Virtual Reality Glasses on Pain During Burn Dressing
Günaydın, Ç., & Güneş, A. (2024) · Kocaeli Üniversitesi Sağlık Bilimleri Dergisi · doi:10.30934/kusbed.1345356
Examining Environmental Influences on Pain Perception Using Virtual Reality
Cardenas, X. M. D. P., & Mejia-Puig, L. (2024) · UF Journal of Undergraduate Research · doi:10.32473/ufjur.26.135393
“A study by Hoffman et al. (2000) examined the impact of VR on the pain relief of burn patients who were receiving physical therapy treatment, finding significant decreases in anxiety, the unpleasantness of pain, intensity of pain, and total time spent thinking about pain.”
BackgroundVanderstraeten, A.-L., Boukaidi, S. A., Cruzel, C., Dumont, C., & Delotte, J. (2024) · Gynécologie Obstétrique Fertilité & Sénologie · doi:10.1016/j.gofs.2024.10.011
Zhou, L., Zhang, J., Zeng, M., & Zhang, L. (2024) · Chinese Science Bulletin (Chinese Version) · doi:10.1360/tb-2024-0470
Zenooz, G. H., Taheriazam, A., Rezaeian, T., Mokhtarinia, H. R., Zenooz, A. M., Shokouhyan, S. M., Hosseinzadeh, S., & Mosallanezhad, Z. (2026) · BMC Musculoskeletal Disorders · doi:10.1186/s12891-026-10507-7
Interactive Virtual Rooms: A New Approach to Anxiety and Pain Management
Moita, N., Almeida, L., & Menezes, P. J. (2024) · International Conference on Graphics and Interaction (ICGI) · doi:10.1109/icgi64003.2024.10923759
“During the study, one of the original creators stated "Patients reported significantly less pain when distracted with VR, with “worst pain” ratings during wound care dropping from “severe” to “moderate” [5].”
Virtual Reality-Assisted Breathing Exercises: A Feasibility StudyPreprint
Kusuma, K. (2025) · SSRN Electronic Journal · doi:10.2139/ssrn.5224191
Prophylactically Limiting Phantom Limb Pain using Collaborative Virtual Reality
Johnsen, K., Frix, J. T., Serbin, R., Gaston, G. R., Loeffler, B. J., Bowmar, E., & Ahn, S. J. (2025) · IEEE Conference on Virtual Reality and 3D User Interfaces Abstracts and Workshops (VRW) · doi:10.1109/vrw66409.2025.00192
“Given that one of the great success stories of virtual reality (VR) has been pain reduction [4], a VR application specifically tailored for amputees could also be valuable, helping to alleviate acute and chronic phantom-limb pain, reducing dependence on opioids and leading to a higher quality of…”
SAĞLIK ALANINDA SANAL GERÇEKLİK UYGULAMALARI
Özmen, B., & Ceyhan, A. (2025) · Samsun Sağlık Bilimleri Dergisi · doi:10.47115/jshs.1534491
Mabrouk, A., Peuchot, H., Jacquet, C., Onishi, S., & Ollivier, M. P. (2025) · Journal of Experimental Orthopaedics · doi:10.1002/jeo2.70301
“VR has demonstrated signi fi cant capability in patients' distraction from pain and reduction of perioperative anxiety, through immersion in a virtual pacifying environment, with subsequent reduction in the perceived pain and anxiety intensity [22, 29].”
Fernández, J. M., Gonçalves-Sánchez, J., Muriel-Villoria, C., Gonçalves, J. M., & López‐Millán, J. M. (2025) · JMIR Research Protocols · doi:10.2196/64781
“Distractions can be active (immersive), involving patient participation by manipulating the environment, or passive (non-immersive), involving only observation [7].”
Virtual Reality: A New Tool for Anxiolysis, Distraction, and Analgesia
Mason, K. P., & Hoffman, H. G. (2025) · Springer eBooks · doi:10.1007/978-3-031-68468-5_44
Self-citationNon-pharmacological Strategies Toward Integrated Procedural Comfort Care
Sahyoun, C., Cozzi, G., & Barbi, E. (2025) · Springer eBooks · doi:10.1007/978-3-031-68468-5_38
Javelot, M., Chopin, C., Bolko, L., Hittinger, A., Geoffroy, M., Charlot, I., Adeline, F., Coutureau, C., Duvivier, A., & Salmon, J. (2025) · Healthcare · doi:10.3390/healthcare13182376
“Median pain score during the first injection was 3 [1; 6] vs. 4 [2; 6] in groups 1 vs. 2, respectively, and 5 [3; 7] vs. 5 [2; 7] during the second injection in groups 1 vs. 2, respectively.”
InfluentialBeebe, K., Alvarez, A., Nguyen, L., Petros, J., Trujillo, M. S., & Aygün, O. (2025) · Journal of Medical Extended Reality · doi:10.1177/29941520251381338
GAMETHERAPY EFFECTS ON PATIENT REHABILITATION AT A BURNS INTENSIVE CARE UNIT: A PILOT STUDY
Calixto, F. A. F., de Carvalho, F. O., Silva, J. P. R., Silva, M. J. D. S., Lima, P. V. P., Araújo, A. A. D. S., & Nunes, P. S. (2025) · Aracê. · doi:10.56238/arev7n10-164
Global survey on perioperative immersive virtual reality for patient distraction in hand surgery
Lattré, T., Brutus, J. P., & Decramer, A. (2025) · Hand surgery & rehabilitation · doi:10.1016/j.hansur.2025.102522
Armstrong, M., Williams, H., Faith, E. F., Ni, A., & Xiang, H. (2026) · JMIR Research Protocols · doi:10.2196/87207
“Various forms of distraction have been found to be effective at reducing subjective pain [10,18], decreasing pain-related brain activity [19], and increasing positive procedural outcomes [20] in pediatric populations.”
InfluentialThe role of virtual reality in nasal procedures: a randomized controlled trial
Alotaibi, N. H., Alromaih, S., Alshenaifi, L. A., Alshareef, N., & AlKhashan, R. (2025) · Annals of Medicine and Surgery · doi:10.1097/ms9.0000000000004313
“…the advantages of VR in enhancing patients’ overall experiences during various procedures, such as wound dressing changes for burn victims [ 10–12 ] , venipuncture [ 13 , 14 ] , bone marrow aspiration [ 15 ] , chemotherapy administration [ 16 ] , lumbar punctures [ 17 ] , and dental…”
Using virtual reality to help reduce pain during severe burn wound-care procedures
García‐Palacios, A., Hoffman, H. G., Cain, V., Tininenko, J. R., Schmidt, A. E., Villa, H., & Patterson, D. R. (2004) · Elsevier eBooks · doi:10.1016/b978-0-443-07247-5.50005-5
Self-citationVijayaalayan, J., & Wimalaratne, P. (2026) · Smart innovation, systems and technologies · doi:10.1007/978-3-032-10951-4_6
Wen, D. O. N. G., Shen, P., Yaowu, W. A. N. G., Mei, L., & Dai, D. (2026) · Journal of Environmental Psychology · doi:10.1016/j.jenvp.2026.102931
Ruiz‐Zaldibar, C., Sánchez‐López, M. I., Lluesma-Vidal, M., Martínez‐Fleta, M. I., Gutiérrez‐Alonso, G., Tomás‐Saura, I., & García‐Garcés, L. (2026) · Virtual Reality · doi:10.1007/s10055-026-01359-6
“This can make their reactions more intense and consequently, increase their HR (Hoffman and Richards 2008 ).”
Differentiating video game expertise using the Model of Domain Learning
Leif, S. A., McCreery, M. P., Krach, S. K., Schrader, P. G., & Abarbanel, B. (2026) · Frontiers in Education · doi:10.3389/feduc.2026.1794086
Armstrong, M., Williams, H., Faith, E. F., Ni, A., & Xiang, H. (2026) · medRxiv · doi:10.64898/2026.04.21.26351381
Desdentado-Guillén, J. M., González-Lara, C., Guerrero-González, C., García‐López, H., Obrero‐Gaitán, E., & Cortés‐Pérez, I. (2026) · Musculoskeletal Science and Practice · doi:10.1016/j.msksp.2026.103563
RehabXR: A Framework for Integrating Virtual Reality with Physiotherapy
Vasagadekar, S., Kshirsagar, S., Rajguru, R., Jaiswal, S., Songira, J., & Chopade, R. (2026) · International Conference on Emerging Technologies and Future Innovations (ETFI) · doi:10.1109/etfi68128.2026.11484643
“Some studies suggest VR can help recondition the brain’s map of the affected body area, known as virtual embodiment [29], [30].”
Virtual reality for pain and anxiety reduction during venous puncture procedures
Rosenecker, A., Amato, M., Geiger, I., Winkler, S., Willeit, P., Schennach, H., & Siller, A. (2026) · Wiener klinische Wochenschrift · doi:10.1007/s00508-026-02763-3
Sebastien, J., Zhu, J., Chirico, A., Mancuso, V., MARKS, A., Soffer, G., & Won, A. S. (2026) · Augmented Humans International Conference (AHs) · doi:10.1145/3795011.3795032
“For decades, virtual reality (VR) has been used to help people transcend physical pain [23, 37, 38, 40, 91, 95]; from burn-related acute pain [36, 37] to chronic pain conditions such as Complex Regional Pain Syndrome [42, 52, 70] or phantom limb pain [7, 35, 74, 83].”
Zheng, L., Wang, T., & Shen, T. (2026) · ANZ Journal of Surgery · doi:10.1111/ans.70775
Woodson, L. C., McQuitty, A. L., Martyn, J. A. J., Talon, M. D., & Sherwood, E. R. (2026) · Elsevier eBooks · doi:10.1016/b978-0-323-88389-4.00021-x
Effects of Virtual Reality Interventions on Pain and Anxiety in Burn Care
Zielina, M., Dostál, D., Raudenská, J., Šmahaj, J., Zajíček, R., Doležal, D., & Javůrková, A. (2026) · Pain Management Nursing · doi:10.1016/j.pmn.2026.05.029
Argaw, M. M., Jingili, N., Oyelere, S. S., & Nyström, M. B. T. (2026) · JMIR XR and spatial computing. · doi:10.2196/66713
“Alongside VR, gamification—the integration of gamelike elements such as points, levels, and rewards—has been shown to improve motivation and sustain engagement in therapeutic contexts [17-19].”
Eye-Tracking-Based Modeling of Emotional and Engagement States in Human–Computer Interaction
Wang, J., Ma, X., Wen, H., & Xue, J. (2026) · International Conference on Computer Supported Cooperative Work in Design (CSCWD) · doi:10.1109/cscwd68734.2026.11581589
“With the rapid development of Virtual Reality (VR) technologies [1], immersive interaction has become an essential component of intelligent systems [2], showing promising potential in various fields such as education [3], healthcare [4], and gaming [5].”
Hadjiat, Y., Marchand, S., & Poisbeau, P. (2025) · Dunod eBooks · doi:10.3917/dunod.poisb.2025.01.1706
Serra, E. (2025) · Dunod eBooks · doi:10.3917/dunod.poisb.2025.01.2770
Zhu, A.-K., Zhang, J., Chen, Y.-M., Huang, H.-L., Lin, S.-L., Wang, W., Pan, X.-J., Luo, J.-W., & Luo, J.-W. (2026) · European Journal of Surgical Oncology · doi:10.1016/j.ejso.2026.112042
Immersive virtual reality for pediatric burn pain and early rehabilitation
Lu, L., Li, W., Ye, S., & Dai, P. (2026) · Frontiers in Pediatrics · doi:10.3389/fped.2026.1876793 · Cited by 1
“Earlier studies have also shown that immersive VR games can produce clinically meaningful pain relief during pediatric burn dressing procedures, with subjective pain scores decreasing by approximately 30% – 50% compared with standard care (30, 31).”
Galland, A., Meyer, A., Blanié, A., Amiot, A., Carbonnel, F., Boytchev, I., & Martin, A. (2026) · Frontline Gastroenterology · doi:10.1136/flgastro-2026-103646
The Role of Cross-Modal Vision-Touch Interaction in Generalized Anxiety Regulation
Xu, J., Li, Y. L., Zhang, A., Shen, J., & Huang, G. (2026) · International Conference on Intelligent Engineering and Next-Gen Healthcare Systems (IEHNS) · doi:10.1109/iehns68708.2026.11607048
“Physical touch provides immediate stress relief and improves psychological states, while the combination of breathing and tactile stimuli, as natural and controllable forms, plays a dual role in emotional regulation[10].”
Portillo, M. D. C. M., Biedma-Perea, M., Marchena, C. S., Caleza-Jiménez, C., Chandler-Gutiérrez, L., del Valle, L. M. L., & Segura-Egea, J. J. (2026) · Dentistry Journal · doi:10.3390/dj14080517
“Hoffman et al. [18] described VR headsets as systems that project images directly onto the user’s eyes while blocking environmental stimuli, thereby promoting a greater sense of immersion.”
Pain Perception in Immersive Virtual Reality and Mixed Reality with the Cold Pressor Task
Kuznetsov, M., Elor, A., & Kurniawan, S. (2026) · SeGAH ... IEEE ... International Conference on Serious Games and Applications for Health/IEEE International Conference on Serious Games and Applications for Health · doi:10.1109/segah69272.2026.11653321
“Immersive virtual reality (VR) as a method of distraction to modulate pain perception has been explored since the early 2000s, primarily being spearheaded by the trials in burn wound care by Hoffman et al. [11].”
Zhang, L., Zhang, X., Zhang, R., Yu, Y., Yang, Z., & Yang, L. (2026) · Frontiers in Neurology · doi:10.3389/fneur.2026.1922187
He, X., & Yong, X. (2026) · Frontiers in Virtual Reality · doi:10.3389/frvir.2026.1889087
Hladky, S., Egloff, C., Peyronnet, V., Mandelbrot, L., & Picone, O. (2026) · Journal of Gynecology Obstetrics and Human Reproduction · doi:10.1016/j.jogoh.2026.103280
Baroni, M., Gursesli, M. C., Duradoni, M., Colombini, G., Thawonmas, R., Galeote, D. F., Thawonmas, R., Hamari, J., & Guazzini, A. (2026) · International Journal of Human-Computer Interaction · doi:10.1080/10447318.2026.2728932
Recuperación psicosocial y reintegración de los pacientes quemados
Blakeney, P. (2009) · Elsevier eBooks · doi:10.1016/b978-84-458-1938-8.50047-7
Shifting Paradigms in Clinical Psychology
Dimeff, L. A., Paves, A. P., Skutch, J. M., & Woodcock, E. A. (2014) · Oxford University Press eBooks · doi:10.1093/oxfordhb/9780199328710.013.031
Metadata
- Authors
- Hoffman, H. G., Doctor, J. N., Patterson, D. R., Carrougher, G. J., & Furness, T. A.
- Affiliations
- University of Washington (US)
- Corresponding author
- Patterson, David R.
- Venue
- Pain
- Published
- 2000-03-01
- Volume
- 85
- Issue
- 1
- Pages
- 305-309
- ISSN
- 0304-3959 (ISSN-L)
- OpenAlex
- W2034120147
- Cited by
- 651
- References
- 36
- Citations by year
- 2026: 30 · 2025: 29 · 2024: 43 · 2023: 46 · 2022: 42 · 2021: 50 · 2020: 46 · 2019: 31 · 2018: 31 · 2017: 30 · 2016: 19 · 2015: 15 · 2014: 30 · 2013: 11 · 2012: 20
- FWCI
- 14.77
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Pain (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- National Institute of General Medical Sciences (GM42725-07, R01GM042725)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
- Physical Sciences › Computer Science › Human-Computer Interaction › Virtual Reality Applications and Impacts
- Health Sciences › Medicine › Surgery › Burn Injury Management and Outcomes
- Keywords
- virtual reality, burn wound care, procedural pain, distraction therapy, non-pharmacological analgesia, adolescents, opioid analgesics, pain intensity, anxiety, video games, staple removal, acute pain management
- MeSH terms
- Adolescent, Burns, Computer Graphics, Humans, Male, Pain, Pain Measurement, User-Computer Interface, Pain Management
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
