|
Boggy |
The peri-wound can become soft and mushy as too much moisture is retained next to the skin or if underlying tissue is starting to decompose such as a deep tissue injury.
|
|
Callus |
A Callus strangulates the wound and prohibits healing. A callus is an indicator of pressure. Mostly seen on diabetic foot ulcers.
|
|
Treatment of
|
Treatment for a callus is debridement with a curette or scalpel. Along with dressings applied to the wound, an offloading shoe with felt are needed to help offload pressure and therefore decrease the build up of a callus. A Total Contact Cast (TCC) can also be applied by a provider to remove any degree of pressure.
|
|
Color |
Erythema (Red) most likely means infection, trauma, or inflammation.
White or maceration means there is too much moisture. The dressing needs to be changed more often or a skin barrier needs to be applied. Blue (cyanosis) poor perfusion, trauma -Purple signifies trauma |
|
Excoriation |
Excoriation is the disruption of the epidermis or dermis caused by scratching, abrasion, chemical or thermal injury. Exposure to urine, feces, bodily fluids, wound exudate, or friction can also be the cause. |
|
Hemosiderin Staining |
Hemosiderin staining is caused by iron-containing pigment carried by red blood cells (RBC). When RBC’s leak into the tissue they break down and leave hemosiderin behind, which causes a characteristic brown pigmentation, commonly seen in patients with venous hypertension.
|
|
Maceration |
The changes and subsequent disintegration of skin resulting from prolonged exposure to moisture. Tissue changes frequently appear white.
|
|
Epibole |
|
Rolled edges of the wound. This prevents further healing because the wound thinks that it is healed. Edges need to be debrided and refreshed.
|
|
Undermining |
Area of tissue destruction under intact skin involving a significant portion of the wound edge. Larger area than tunneling.
|
|
How to Measure a Wound |
I would highly suggest when measuring depth to use metal forceps to accurately place the location instead of using fingers. This will give a more accurate reading than using your fingers.
|