Chronic Wound Assessment and Management: Important Terms to Know

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Advanced treatment modalities: Wound care interventions that are typically applied when standard of care treatments have failed to lead to significant wound closure progress. Treatments include collagen products, cellular and/or tissue-based products, negative pressure wound therapy, hyperbaric oxygen therapy, and others.

Full-thickness wound: Tissue damage involving total loss of epidermis and dermis and extending, at the minimum, into the subcutaneous tissue and possibly through the fascia, muscle, or bone.

Granulation tissue: Tissue found in wounds beginning to heal. It is marked by pink or red tissue and may appear moist or shiny with an irregular or granular surface. Granulation tissue contains new vessels, tissue, fibroblasts, and inflammatory cells.

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Hyperbaric oxygen therapy: Hyperbaric oxygen therapy devices utilize chambers to provide oxygen to all tissues of the body by pressurizing an individual to greater than one atmosphere while breathing surface equivalent mixtures in excess of 100%. Hyperbaric oxygen therapy is indicated for chronic problem wounds caused by diabetes, venous or arterial insufficiency, crush injuries, and wounds or tissue damage caused by the late effects of radiation therapy. Systemic therapy may be part of a procedure billed using a CPT® code, and reimbursement is dependent on individual local coverage determinations.

Inflammatory phase: The body’s natural response to injury. Once hemostasis is achieved, blood vessels dilate to increase blood flow, thereby allowing antibodies, white blood cells, growth factors, enzymes, oxygen, and nutrients into the injured area. This phase is characterized by redness, pain, warmth, and swelling.

Ischemic wound: A wound that results from diminished or blocked blood supply to vascular beds in the body. In the absence of an active infection, debridement is not recommended.

Necrosis: A condition in which tissue is no longer viable. It can manifest as either slough or eschar.

Negative pressure wound therapy (NPWT): The use of a sealed wound dressing attached to a vacuum pump. This therapy draws fluid away from the wound and can help manage bioburden levels on a surgical wound, thus reducing the risk of developing a surgical site infection.

Palliative wound care: Wound care focused on relieving suffering and improving the patient’s quality of life when their wounds no longer respond to, or the patients can no longer tolerate, curative treatment. Palliative care focuses on symptom management, addressing the problems of infection, pain, wound odor, exudate, malnutrition, and decreased self-confidence. Palliative care may coincide with end-of-life care.

Partial-thickness wound: Tissue damage involving only the first two layers of skin, the epidermis and the dermis. Wounds that involve anything below the dermis are considered full-thickness.

Recalcitrant wounds: Wounds that have stalled and failed to progress as expected. A wound can be considered recalcitrant if it does not decrease in size by 30% in three weeks or 50% in four to five weeks.

The views and opinions expressed in this blog are solely those of the author, and do not represent the views of WoundSource, HMP Global, its affiliates, or subsidiary companies.

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