Tissue Involvement – How Deep is Your Wound?

Sometimes, it seems as though all the anatomy and complex terminology that we learn during our training is…(dare we say it)… somewhat less than essential in a great many of the situations we encounter in our everyday practice. There may seem little advantage in being intimately acquainted with the scientific names of all the layers of the skin, for example, when faced with a patient suffering in agony over a particularly difficult wound. However, it is only by understanding the normal structure of skin, from the integument to the subcutaneous tissues and deeper tissues, that a clinician is able to accurately determine the extent of tissue involvement in the wound, and therefore administer the appropriate treatment.

Tissue Involvement Categorization

The extent of tissue involvement in a wound is typically categorized into three groups:

  1. Superficial wounds – Affect only the epidermis and involve partial removal of the integument to reveal the top layer of the dermis. Superficial wounds are typified by the scrapes and grazes constantly present on the knees of most 4-year olds, as well as by superficial (first-degree) burns.
  2. Partial-thickness wounds – Involve the epidermis and part of the underlying dermis, and may include deep sunburn, stage II pressure ulcers or Wagner grade 1 ulcers.
  3. Full-thickness wounds – These are the deepest wound type, involving the epidermis and dermis and possibly also extending into the subcutaneous tissue, fascia, and muscle. Full-thickness burns, stage III pressure ulcers and Wagner grade 2-5 ulcers are examples of full-thickness wounds.

Identification & Assessment

It is only by correctly identifying the types of tissue involved in a wound, and therefore the depth of tissue involvement, that a wound be properly assessed and the correct course of treatment initiated. Suddenly, all that late-night studying over the names and properties of the different layers of the skin seems more worthwhile.

To refresh your knowledge on the anatomy of the skin, and to enhance your expertise in all aspects of wound management, consider becoming certified in wound management. A wound management certification course covers all aspects of the skin and wounds and is the ideal way to improve your knowledge, learn new skills and demonstrate your commitment to the subject.

Learn More With Our Wound Care Education Options

Interested in learning more about wound care and certification? Browse through our wound care certification courses for information on our comprehensive range of education options to suit healthcare professionals across the full spectrum of qualifications and experience.


Myers BA. Wound management principles and practice. 2nd ed. Upper Saddle River, NJ: Pearson; 2008.

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