The Basics of Wound Examination

Previous articles in this series have considered the importance of a full patient examination and systems review as part of a wound assessment. While these elements are essential and provide a great deal of vital information, nothing can substitute for a thorough and detailed assessment of the wound itself. A careful wound examination is important to drive management strategies, and also to provide full documentation against which healing progress can be measured.

Characteristics, Location, Size

A full wound examination should record details of the wound characteristics, location, and size as an initial assessment. Wound location can provide important information about the etiology of the wound and can also direct therapeutic interventions and wound dressing choices. Wound size can be measured directly using measuring sticks, through wound tracings or photography or via volumetric measurement. Whichever method is chosen to record the size of the wound, it is essential that it is then used consistently for every subsequent measurement.

Other wound characteristics that should be described and documented for every wound examination include the wound bed, wound edges, level of drainage, as well as the wound odor and color. The structure and quality of the periwound and associated skin should also be examined, and the presence of tunneling or undermining recorded. The presence and quality of the epithelial appendages can also give useful insights into the etiology of the wound, with an absence of hair suggesting long-standing ischemia and a thick and discolored nail indicating a fungal infection.  Furthermore, the presence of edema or induration or an abnormally raised temperature can suggest wound infection, which should be dealt with as a priority.

Systematic Approach & Evidence

The medical profession has been describing wounds for centuries, and many of the same characteristics and measurements are recorded today. The systematic approach that is adopted in modern medicine, however, provides a full record of each and every wound, allowing appropriate management decisions to be taken, enabling progress toward wound closure to be measured, and providing a file of evidence to support all clinical decisions.

To learn more about wound examination and refresh your knowledge in other critical areas of wound management, you may wish to consider becoming certified in wound management. As well as ensuring that your knowledge is fresh and current, a certification in wound management demonstrates your commitment to the area and may improve your job prospects and career opportunities.

Learn More With Our Wound Care Education Options

Interested in learning more about wound examination and wound care? 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.

References

1. Ahn C, Salcido R. Advances in wound photography and assessment methods. Adv Skin & Wound Care. 2008; 21: 94-95
2. Grey JE, Enoch S, Harding KG. Wound assessment. BMJ 2006; 332: 285
3. Hess CT. Assessing the total patient. Adv Skin & Wound Care. 2008; 21: 192.
4. Myers BA. Wound management principles and practice. 2nd ed. Upper Saddle River, NJ: Pearson; 2008.