Type of wounds: Key Terms & Definitions in Medicine

Arterial wounds: description

Decrease in circulation (improper oxygen and blood supply)
Cooler in temperature
Dry in nature

With an arterial wound near the ankle what should you be comparing

Ankle pulse to wrist pulse

Venous ulcers: description

Warm/normal temperature
Wet and more moist
Causes issues with maceration
No circulation issues

Pressure ulcer: location

Sacrum
Ischial tuberosity
Heels
Occiput
Ears
Spine of scapula
Greater trochanter

Pressure ulcer: ABI

Normal: 1.0-1.3

Pressure ulcer: pulse

Normal

Pressure ulcer: pain

Variable

Pressure ulcer: wound size

Variable

Pressure ulcer: wound shape

Circular, triangular, irregular

Pressure ulcer: wound edge

Variable
Symmetrical: greater trochanter
Irregular: coccyx

Pressure ulcer: wound depth

Variable

Pressure ulcer: wound bed/apperance

Variable
Depends on wound depth

Pressure ulcer: edema

Normal-minimal

Pressure ulcer: staining

Absent

Pressure ulcer: exudate/drainage

Variable

Arterial wound: location

Distal lower extremity
Lower 1/3 of leg
Lateral malleolus
Foot dorsum
Toes

Arterial wound: ABI

Concern with circulation: <=0.8
Pain with activity: 0.6-0.8
Pain at rest: <=0.5
Critical: <=0.4

Arterial wound: pulse

Absent (distal to wound)

Arterial wound: pain

+ to ++
increased with activity

Arterial wound: wound size

Small

Arterial wound: wound shape

Circular
Punched out

Arterial wound: wound edge

Cliff
Stair step

Arterial wound: wound depth

Shallow to deep

Arterial wound: wound bed/aperance

Pale
Slough (2 degree decrease in circulation)

Arterial wound: edema

Minimal, localized

Arterial wound: staining

Absent

Arterial wound: exudate/drainage

Minimal

Venous wound: location

Lower extremity
Below the knee
Medial malleolus

Venous wound: ABI

>=0.8 is typical

Venous wound: pulse

Normal

Venous wound: pain

+ or -
increased with dependent position

Venous wound: wound size

Large

Venous wound: wound shape

Irregular

Venous wound: wound edge

Gradually deeper toward center

Venous wound: wound depth

Shallow

Venous wound: wound bed/apperance

Wet
Slough (slow granulation)

Venous wound: edema

Moderate to large

Venous wound: staining

Moderate to large hemosiderin (purple)

Venous wound: exudate/drainage

Moderate to heavy

Neuropathic ulcer: location

Usually foot (top, sides, bottom, below metatarsal heads)

Neuropathic ulcer: ABI

Unreliable

Neuropathic ulcer: pulse

Varies
No pedal

Neuropathic ulcer: pain

Decreased/absent

Neuropathic ulcer: wound size

Variable

Neuropathic ulcer: wound shape

Circular, oval

Neuropathic ulcer: wound edge

Round or oval with callous

Neuropathic ulcer: wound depth

Often deep

Neuropathic ulcer: wound bed/apperance

Eschar to granulation

Neuropathic ulcer: edema

Localized

Neuropathic ulcer: staining

Absent

Neuropathic ulcer: exudate/drainage

Low to moderate