Terms to Know: Wound Bed Preparation

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by the WoundSource Editors

Bacterial load/burden: Presence of bacterial pathogens in an open wound contributing to wound chronicity and persistence of inflammatory cycle. There are several points along the spectrum of bacterial presence in chronic wounds: contamination, colonization, critical colonization, infection, and sepsis.

Debridement: The procedural act of removing non-viable tissue, along with any debris, from the wound. There are multiple debridement modalities, some of which are selective for non-viable tissue and some which are non-selective (viable tissue is removed as well, e.g., mechanical debridement with gauze sponges): sharp (conservative or excisional/surgical), mechanical, autolytic, enzymatic/chemical, and biological.

Epithelial migration/epithelial resurfacing: Development and movement of epithelial cells across the surface of the wound bed/granulation tissue. This process can originate from the margin/edge and/or from any remnant dermal appendages (e.g., hair follicles).

Exudate: Fluid drainage originating from tissue in the wound bed in response to injury or inflammation. Exudate types: serous/clear, sanguineous/bloody, purulent, seropurulent. Exudate quantity: none, scant, small/minimal, moderate, large, copious.

Maceration: Tissue damage caused by excessive moisture in the wound bed, on the wound edge, or over the periwound area. The area may appear lighter than surrounding tissue or completely white and is typically considered non-viable tissue.

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Non-viable tissue: Tissue that has lost the ability to undergo normal cellular metabolism or biological activity. Other commonly used terms include devitalized or necrotic tissue.

Occlusive dressing: A category of wound dressing that decreases water vapor and heat loss. It is utilized to maintain a moist environment in wounds requiring assistance with moisture balance and may be used to assist with autolytic debridement in wounds requiring removal of non-viable tissue where more expeditious debridement modalities are not indicated.

Pathogen: Any agent (viral, bacterial) capable of producing infection or disease in a host.

Wound bed: The level of tissue in a wound containing viable cells, or wound base.

Wound contraction: A process wherein the edges of full-thickness wounds are physically drawn together, thus decreasing wound size, accomplished by specialized contractile cells known as myofibroblasts.

Wound edge: The area where intact epithelium meets the wound bed/base. Edge descriptors: indistinct, attached, unattached, rolled/epibole, hyperkeratotic/callused, fibrotic/indurated.

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

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