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Important Terms to Know: Complex Wounds

Practice Accelerator
February 28, 2023

Acute wound: An alteration in skin integrity, such as a simple laceration or a surgical wound, that typically moves through the healing process and heals in a predictable timeframe without complication. An acute wound results from a documentable event with the assumption that it will progress normally through the 4 phases of wound healing. An acute wound follows a predicted pattern of healing that should result in complete functional closure.

Ankle-brachial index (ABI): The calculation of the ankle's systolic pressure divided by the arm's systolic pressure. The ABI provides a simple way to assess for peripheral arterial disease.

Arterial ulcer: Also known as arterial insufficiency ulcer, or ischemic ulcer, this lesion is a localized defect, excavation of the skin, or underlying soft tissue that stems from predisposing factors, including peripheral vascular disease, diabetes mellitus, and advanced age, resulting in inadequate blood supply. Typically, arterial ulcers have a deep, pale wound bed with distinct margins.

Burn, deep partial-thickness (deep second-degree): Deep partial-thickness (deep second-degree) burns extend through the epidermis and into the dermis. The dermis is divided into 2 regions: the papillary region, composed primarily of connective tissue, and the reticular region, which includes hair follicles, sebaceous glands, sweat glands, cutaneous sensory receptors, and blood vessels. Deep partial-thickness burns extend into the reticular region of the dermis and can lead to significant scarring.

Complex wound: A wound with one or more complicating factors, such as exudate, infection, comorbidity, or polypharmacy. Complex wounds can be acute or chronic wounds that defy a cure with conventional therapies. Treating complex wounds generally requires a multidisciplinary approach.

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Diabetic foot ulcer – neuropathic: Diabetic neuropathic foot ulcers form because of peripheral neuropathy over pressure points on the foot, which lead to extended microtrauma, breakdown of overlying tissue, and eventual ulceration. In addition, neuropathy can result in minor scrapes or cuts that may develop into ulcers if not properly treated. The wound margins will have a well-defined, punched-out look, and the surrounding skin will often be calloused. The depth of the wound typically depends on the thickness of the callous. Often there will be undermining in the wound, or underlying pockets of infection, which can, in turn, lead to osteomyelitis if left untreated.

Infected wound: A localized defect or excavation of the skin or underlying soft tissue in which pathogenic organisms invade viable tissue surrounding the wound. Clinical presentation includes fever, erythema, edema, induration, increased pain, and a change in drainage to purulent. A tissue biopsy and/or culture test should be taken to identify the wound pathogens to determine the appropriate treatment.

Mixed-etiology ulcer: This term refers to foot ulcerations in patients with diabetes that are multifactorial and are often confounded by concomitant issues such as ischemia.

Moisture-associated skin damage (MASD): This is the general term for inflammation or skin erosion caused by prolonged exposure to a source of moisture, such as urine, stool, sweat, wound drainage, saliva, or mucus. Experts propose that for MASD to occur, another complicating factor is required, in addition to moisture exposure. Possibilities include mechanical factors (friction), chemical factors (irritants contained in the moisture source), and microbial factors (microorganisms). The 4 classifications of MASD are periwound moisture-associated dermatitis, peristomal moisture-associated dermatitis, incontinence-associated dermatitis, and intertriginous dermatitis.

Venous ulcer: Also known as venous leg ulcer, venous stasis ulcer, or venous insufficiency ulcer, a localized defect or excavation of the skin or underlying soft tissue that occurs because of predisposing factors, including valve incompetence in perforating veins, deep vein thrombophlebitis and thrombosis, obesity, and advanced age.


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.