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Wound pain can occur and intensify for the following reasons:

• Wound bed gets dry.
  Wounds therefore need to stay moist. Also movement of proliferating
  cells during the repair process occur smoothly through liquid
  interface. When wounds dry out, cells will tend to go downward
  to seek moisture delaying the healing process. Choose dressings
  which provide optimal environment for healing (those which keep the
  wounds moist). Some wounds tend to drain more and absorptive
  dressings might be chosen to reduce/prevent congestion due to
  fluid overload. Care should be taken with these dressings which
  do a good job absorbing excess drainage but tends to dry up the wounds.
• Wound bed temperature is below body temperature causing
  capillary narrowing, slowing circulation and causing pain.
  In severe cases of cold exposure, ischemia may even result
  causing even more pain, delay healing and even cause tissue death.
• Wound trauma can also cause pain. When wound beds get dry,
  and dressing stick to the wound bed, each time the dressing is changed causes pain. In some wounds with depth down to the dermis, nerve endings are exposed. Tugging on the wound edges, and the wound bed while removing a dressing which dried and adhered to the wound bed stimulates these nerve endings and cause pain. Choose dressings with minimal loss of moisture to prevent drying of the wound bed and cooling of the wound through moisture loss. Dressings which allow adequate amount of moisture while keeping the wound clean and need not be changed frequently are ideal. Some wounds depending on location also need to be padded for protection against pressure or contact when the limb might come in contact with surfaces or objects.
• Wounds on areas with poor circulation tend to hurt more
  due to ischemia. Patients with poor circulation typically have more
  pain on limb elevation, or when temperature gets cold. Care should also be taken in using compression bandages especially for patients with reduced arterial circulation.
• Infection can also cause pain. Infection triggers inflammation
  and inflammation causes fluid build up. Congestion of capillaries
  can occur due to fluid build up and cause pain. Keep wounds clean
  through observation of good hygiene. Dressings which keep
  bacterial load down also help. If infection is present, this needs to
  be resolved through systemic or topical antibiotics the use of
  which remains the discretion of your physician.
• Fluid build up such as in edema from poor venous return can also cause pain in the wound due to capillary congestion. Control edema through elevation, exercise. In some cases, the physician might decide to place patient on diuretics as well.
• For patients using wound vacs, pain can occur if there is excessive negative (vaccum) pressure on the wounds.
• When wounds are tightly packed, this puts undue pressure on nerve endings and cause pain and wound healing is delayed due to "contact inhibition.
  From:
  Maria Carunungan, PT, DPT, GCS, CWS
  Physical Therapist/Board-certified Wound Care Specialist
  and Geriatric Care Specialist
  West Virginia