Wound types and caractiristics

Preventing wounds are just as important as treating them during palliative care. For this reason, it is important to know what type of wound you are dealing with. Wounds may be classified as acute or chronic based on the source, ie. surgical wounds, burns, traumatic wounds, pressure injuries, venous stasis ulcers, arterial ulcers, diabetic foot ulcers and other atypical chronic wounds.
The wounds typically experienced (but are not limited to) fall into a few common categories, each with its own unique characteristics.

• Pressure wounds
Pressure wounds are seen most often in elderly and terminally ill patients because of skin failure — a naturally occurring process wherein the skin begins to break down and die. Patients who spend most of their time in bed or in a chair often develop pressure wounds. Frequent repositioning is required to reduce the risk of this type of injury. Speciality pillows, airflow mattresses etc. can ease pressure and prevent friction that can lead to abrasions.

Pressure wounds, if left untreated, can advance through 4 stages:
Stage 1: Redness and painful —skin that differs in temperature and texture from the surrounding skin.
Stage 2: Partial loss of outer skin, often with a shallow, open wound with a red wound bed.
Stage 3: Full-thickness outer skin loss. Subcutaneous fat may be visible, but no muscle, bone, or tendon is exposed.
Stage 4: The wound extends deep down, often into muscles or tendons.

• Arm Skin Tear
Skin tears usually occur on the arms and legs of older patients. These wounds are often the result of extreme friction.

Characteristics
1. Often actively bleeding
2. Shallow divides between the outer layers of the skin
3. May have exudate

• Deep Tissue Injury
If the underlying soft tissues in a patient’s body are damaged by continued pressure, deep tissue injuries can begin to form. If left unmanaged, deep tissue injuries can progress quickly, causing the surrounding skin to deteriorate rapidly, forming a more advanced wound.

Characteristics
1. Purple or maroon in colour
2. Dissimilar feeling to the skin surrounding the wound — squishy or quite firm to the touch
3. Dissimilar in temperature to the skin surrounding the wound — warmer or cooler to the touch

• Venous Ulcer
Venous ulcers are ulcers that most often occur on the legs of those who have been diagnosed with some form of venous disease.

Characteristics
1. Shapes are irregular
2. Shallow in depth
3. Most often develop on the lower legs and ankles
4. Usually accompanied by painful swelling

• Malignant Wound
Malignant wounds form when cancer, growing under the skin, penetrates through the skin and forms a wound. As these wounds and the cancer within them progress, the cancer blocks the oxygen supply to the tiny vessels around the skin, starving the skin in that area of the oxygen it needs.

Characteristics
1. Strong malodour
2. Heavy exudate that crusts
3. Purple or maroon in colour
4. Dissimilar in feel to the skin surrounding the wound — squishy or quite firm to the touch
5. Dissimilar in temperature to the skin surrounding the wound — warmer or cooler to the touch