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Patient Information | Wound Care
Glossary of Terms

Ankle brachial pressure index (ABPI)
A hand-held Doppler ultrasound test used to determine the presence and degree of peripheral arterial disease in patients with leg ulcers.
 
Alginate
A dressing made from seaweed, which can be composed of galuronic and mannuronic acid, with the proportions of these determining the gel-forming properties of the final fiber. Best used in moderate- to highly-exuding wounds. If the wound bed is too dry, the alginate will not gel and will adhere to the wound bed. Some alginates have haemostatic [what does this mean?] qualities.

Recommended product: Kaltostat (haemostasis only); Algisite M (moderately heavy exudate)
 
Angiogenesis
This occurs during the proliferative phase of healing when new blood vessels infiltrate the wound and capillaries are formed by endothelial budding.
 
Antibacterial cream
Recommended product: Silver sulfadiazine 1%.
 
Antiseptic impregnated fabric
Recommended product: Povadone iodine fabric dressing (low exudate); Iodoflex/Iodosorb (heavy exudate).
 
Autolysis
The term used for the natural, spontaneous process of devitalized tissue being separated from viable tissue. Together with proteolytic enzymes, macrophage activity is thought to be responsible for autolysis.
 
Blisters
Collection of fluid under the epithelial layer, fluid may be clear or pink/red in color.
 
Carbon-silver dressing
Carbon dressing impregnated with silver. Activated charcoal attracts and traps bacteria and odor. Silver kills bacteria. Both components are effective in wet or dry wounds.
Recommended product: Actisorb silver (charcoal and silver); Carboflex - odour (charcoal)

Cellulitis
Inflammation of the tissues presenting as edema, redness, pain and heat, often with hardness of the tissues and a demarcation of the red area.

Clean technique
Involves using instruments/supplies that are not thoroughly sterilized (completely free of potentially infectious agents). Boxes of non-sterile gloves and gauze that comes many in a package are examples of “clean” supplies. These “clean” supplies are less expensive than “sterile” supplies. Appropriate use of clean technique can save valuable resources while not increasing the risk for infection.

Clean wound
A wound that is in the process of healing; usually it has a bed of healthy granulation tissue (see below) without overlying exudate or surrounding cellulitis.

Colonization
Multiplication of micro-organisms without a corresponding host reaction.

Debridement
The process of removing dead/unhealthy tissue from a wound.

Delayed primary closure
Initially treating the wound with dressing changes, and then, usually after 48 hours when the swelling has diminished and there are no signs of infection, suturing the wound closed.

Dirty wound
A wound covered with proteinaceous debris or eschar, but without surrounding cellulitis.

Eczematous
Acute or chronic inflammation of the skin presenting as redness, irritation, weeping, crusting, or scaly areas.

Edematous
Abnormal collection of fluid in the tissue; skin is swollen, shiny, and tense.
 
Epithelialization
The final stage of wound healing where epidermal cells migrate across the surface of the wound from the wound margins and the remaining hair follicles. These cells are pink/white in color at the wound edges or in islands over the granulation tissue.
 
Erythema
A redness of the skin caused by congestion of capillaries in lower layer of the skin, may be due to injury, infection, inflammation, or hyperaemia.
 
Exudate
The tan/grayish material that is found on the surface of an open wound. It is proteinaceous material that comes from the wound itself. It is not pus. Therefore, the presence of exudate on a wound does not mean the wound is infected.

Film dressings
Used as primary of secondary dressing. Semi-permeable films are made of clear polyurethane coated with an adhesive. They are conformable and resistant to shear and tear. They prevent bacterial colonization but do not absorb exudate.
 
Flap
Tissue (skin/subcutaneous tissue, muscle, fascia, bone, or some combination) with a blood supply that can be moved to cover a wound. Types of flaps:

  1. Local flap - The tissue is adjacent to the open wound.

  2. Distant flap - The tissue is not adjacent to the open wound and must be moved to the defect.

 

c)  Free flap - A distant flap that is completely detached from the body and transferred to the defect. The artery and vein that supply the flap must be reconnected to vessels near the wound.

Foam
A dressing produced from polyurethane, a soft, open cell sheet, and may be single-layer or multiple layers. These are non-adherent, can absorb large amounts of exudates, and can also be used as secondary dressings. They are also available impregnated with charcoal and with a waterproof backing.
Recommended product: Hydrocellular - Allevyn; Hydrofoam - Lyofoam (tracheostomy only); Hydropolymer - Tielle and Tielle Light: shallow wounds, Cutinova cavity: cavity
 
Fragile
Unbroken skin that appears thin, delicate, and likely to be damaged.
 
Granulation
During the proliferative phase of healing, this is the bright red tissue formed from new capillary loops or "buds" that are red/deep pink and moist with a "bumpy" appearance.
 
Haemoserous
Blood-stained fluid when serous fluid mixes with blood, red/pink in color.

Purulent - frank pus coming from the wound indicating infection, yellow/green in color, may be brown/red if infection is causing wound to bleed.
 
Healthy
Normal skin with no breaks and no problems.
 
Hydrocolloid
A waterproof, occlusive dressing that consists of a mixture of pectins, gelatins, sodium carboxymethylcellulose, and elastomers. Hydrocolloids create an environment that encourages autolysis to debride wounds that are sloughy or necrotic. As the hydrocolloid mixes with exudate, it produces a yellow gel with a characteristic odor, which the patient should be told about.

Recommended product: Granuflex/Duoderm
 
Hydrofiber
A highly absorbent wound dressing made up of 100% hydrocolloid (sodium carboxymethylcellulose). The hydrocolloid is spun into fibers and needled to make a soft, non-woven fleece-like dressing that comes as a sheet or ribbon. An alternative to alginate dressing. The dressing retains a high quantity of water without releasing it, thereby forming a thick, conformable gel.

Recommended product: Aquacel
 
Hydrogel
A dressing that comes as a sheet or gel. Sheets are used for shallow or low-exuding wounds. The gels are suitable for cavities and are effective for desloughing and debriding wounds. Gels have a high water content, which aids the rehydration of hard eschar and promotes autolysis in necrotic wounds.

Secondary dressing is required to keep the gel moist and in situ. To prevent possible maceration a protective barrier film may be applied on peri-wound areas.

Recommended product: Intrasite
 

Hydropolymer cavity dressing

Highly absorbent polyurethane dressing consisting of a vapor-permeable foam matrix.
 
Infection
The deposition and multiplication of organisms in tissue with an associated host reaction.
 
Inflammation
Bacteria are killed, foreign matter and toxins are removed, and damaged tissue is walled off. Symptoms are: erythema, raised temperature, swelling, exudates, and pain.
 
Intact
No obvious breaks in the skin surface.
 
Larval therapy
Larval therapy offers an effective approach to wound debridement and removing bacteria. Specially bred, sterile maggots that liquefy dead tissue using enzymes are now available to treat a range of wounds. The treatment appears to have no adverse side effects.
 
Low adherent
Recommended product: Release

Maceration

A softening or sogginess of the tissue owing to retention of excessive moisture that presents as moist, red/white, and wrinkled.
 
Medicated bandages
Recommended product: Calaband bandage, Icthopast bandage, Zinc past bandage (Steripaste).
 

Necrosis
The local death of tissue. This tissue is often black/brown in color and leathery in texture.
 
Necrotic tissue
Dead tissue.

Overgranulation
Granulation tissue that grows above the level of the surrounding skin, preventing epithelial cells from growing across the wound.
 
Paraffin-impregnated gauze
Recommended product: Jelonet, Vaseline
 
Primary closure
Suturing the edges of a wound together to close the wound.

Proliferation/Reconstruction
New granulation tissue is formed to replace lost volume. Epithelial cells grow around the wound, or in islets, to form a new protective covering.
 
Reconstructive ladder
Provides a logical way to think about how to close an open wound, regardless of the etiology of that wound. Whether it is an acute traumatic wound or a wound that resulted from excising a tumor, the same principles apply. This ladder is set up so that if the first “rung” doesn’t work, it will not prevent the next higher “rung” on the ladder from being able to be attempted. The rungs on the ladder are (in increasing order of complexity):

1. Secondary closure - Leave the wound open
2. Primary closure
3. Skin grafting
4. Local flaps
5. Distant flaps - Secondary closure - Allow the wound to heal using dressing changes alone

Skin graft
A thin layer of skin used to cover an open wound. There are two types:

a) Split thickness skin graft - All of the epidermis and part of the dermis is included. The donor site (where the skin graft was taken from) will heal by secondary intention.

b) Full-thickness skin graft - All of the epidermis and all of the dermis is included. Subcutaneous tissue must be removed from the undersurface of the dermis. The donor site must be closed primarily or a large open wound will result.

Semi-permeable adhesive film
Recommended product: Tegaderm, Tegaderm IV
 
Slough
The term for the viscous yellow layer that  often covers the wound and is strongly adherent to it. Its presence can be related to the end of the inflammatory stage of healing when dead cells have accumulated in the exudate.
 
Sterile technique
Uses instruments/supplies that have been specifically treated so that there are NO bacterial/viral particles on their surfaces. Examples of sterilized supplies include instruments that have been autoclaved (subjected to high temperatures to kill microorganisms) and gauze/gloves that have been specially prepared at the factory and are individually packaged. Procedures done in an operating room are usually done using sterile technique.

Stoma products
Recommended product: Comfeel barrier cream, Orabase paste, Orahesive powder, Stomahesive paste
 
Strike-through
The point at which a liquid pathway is formed between the inner and outer surfaces of a dressing by the penetration of blood, exudates, or tissue fluid.
 
Tangential excision
The technique used to excise burned tissue, leaving the uninjured deeper tissue intact. This is done in the operating room under general anesthesia. A special knife is used to remove the burned tissue in thin slices. When healthy tissue has been reached, it bleeds. Dead, burned tissue does not bleed.

Vacuum-assisted closure (VAC)
Vacuum-assisted closure is a system that creates a hypoxic environment within the wound bed in which aerobic bacteria cannot survive. The environment forces the microcirculation to regenerate rapidly and produce large amounts of capillaries. The negative pressure also removes slough, loose necrotic material and exudate from the wound bed.

Wet-to-dry dressing
A dressing technique used to treat a dirty wound or to prevent build-up of exudate on a wound. Apply a saline moistened (damp, not soaking wet) gauze pad to the wound and then cover this with a dry gauze pad. The reason it is called a “wet-to-dry dressing” is that the moist gauze directly on the wound is allowed to dry out. When this bottom layer of gauze is removed, it pulls off the exudate, debris, and non-viable tissue that have become stuck to the gauze. Studies have shown that wound healing is optimized by being in a moist environment, so it is best to not let the dressing completely dry out, making it more of a wet-to-damp dressing.

Wet-to-wet dressing
A dressing technique that will keep a clean wound clean, and promote healing. Apply a saline- moistened (slightly wetter than for a wet-to-dry dressing) gauze over an open wound and cover it with a dry gauze pad. The dressing is removed when it is still wet. If the bottom layer of gauze dries out, pour saline over the gauze prior to removing it.

 

 

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