Wound Basic And Diagnostic

Definitions
Greek word tpavua'
an injury or wound.
Structural alteration and/or physiologic imbalance
that results when energy is imparted or vital
functions compromised during interaction with
physical or chemical agents.
Wide range of mechanisms of injury

Oxford Textbook of Surgery (3-Volume Set) 2nd edition (January 15, 2000): by
Peter J. Morris (Editor), William C. Wood (Editor) By Oxford Press
 Classification by Onset
Acute wound
Recent wound that has yet to progress through
the sequential stages of wound healing.
Chronic wound
wound that is arrested in one of the wound-
healing stages (usually the inflammatory stage)
and cannot progress further.
Usually defined as 30 days
Acute Wounds Chronic Wounds
 Mechanism of Trauma
Blunt
Motor vehicle crash, Fall, Assault, Crush
Penetrating
Stab, Gunshot, Laceration by Foreign bodies
Poisoning
Solid, Liquids
Diving
Burns
Thermal, Electrical, Radiation
Bites and Stings
Oxford Textbook of Surgery (3-Volume Set) 2nd edition (January 15, 2000): by
Peter J. Morris (Editor), William C. Wood (Editor) By Oxford Press
Crush Injury
Blunt trauma
Penetrating Wounds
Thermal Injury
Bites and Stings
 Wounds Type
1. Incised Wounds
- Clean cut, sharp instrument
2. Contused Wounds
- Blunt force, bruising and swelling not breaking the skin
3. Lacerated Wounds
- Tissues tearing jagged, irregular edges
4. Puncture Wounds
- By pointed instruments ice pick, bullet, nail
5. Avulsion Wounds
- Strong shearing forces and friction significant tearing and tissue
destruction
6. Burn Wounds
- thermal, chemical, electrical

Wound and Skin Care Clinical Guidelines

April 2007
Incised Wound
Contused Wounds
Lacerated Wounds
Avulsion Wounds
Puncture Wounds
Burn Wounds
 Classification By Infection Rate
Infection
Classification Wound Characteristic
Rate (%)
Atraumatic, uninfected, no entry of GU, GI or
Clean (Class I) 1.5 5.1
respiratory tract (RT)
Clean
Minor break in sterile technique, entry of GU, GI
Contaminated 7.7 10.8
or RT without significant spillage
(Class II)
Contaminated Traumatic Wounds, gross spillage into infected
15.2 16.3
(Class III) tissue, bone, urine or bile
Drainage of abscess, debridement of soft tissue
Dirty (Class IV) 28.0 40.0
infection

ACS Surgery, Principles and Practice (2004)

Wound Healing Stage Classification
Epithelialsing Tissue
Translucent colour, small island of epithelial cells from hair follicels,
sebaceous sweat glands.
Granulating Tissue
Granular, slightly uneven, pinky red colour
Sloughy Tissue
Yellow, dry / slimy, adherent to wound bed
Infected Tissue
Inflamation, pus, odor, pain, exudate, dark
Necrotic Tissue
Black leather, hard skin, depth unknown
Malignant (Fungating) Tissue
Raised malignant tissue, bleeds, odor to bacterial colonisisation
 Epithelialising Tissue
Translucent colour
small island of epithelial cells
from hair follicels, sebaceous
sweat glands.
Granulating Wound
Granular, slightly uneven,
pinky red colour
 Sloughy Tissue
Yellow, dry / slimy, adherent to
wound bed
 Infected Tissue
Inflamation, pus, odor,
pain, exudate, dark
 Necrotic Tissue
Black leather, hard skin, depth
unknown
Malignant Tissue
 The wound characteristics (size, depth,
infection, necrotic tissue component, edema,
drainage) are documented, and local wound
care is initiated
 Consult to the consultant
open fractures of long bones
nerve or vascular injuries
exor tendon disruptions
joint capsule disruptions
repair of specialized structures, such as the
parotid or lacrimal duct
replacement of skin loss by a ap or graft
extensive debridement