Wound Diagnosis

Diagnosing Chronic Wounds

Wounds fail to properly heal for a number of reasons including a lack of good supply of blood, oxygen and nutrients and a clean and infection-free environment. A critical stage in the care of wounds is to remove the element preventing the healing process to progress, as in cases of wounds caused by weight-bearing or wounds that are under constant pressure. When wounds do not get relief from constant pressure, there can be a cumulative breakdown of the tissue, which ultimately lengthens the wound healing process.

Our wound care team uses a variety of diagnostic methods to help assess the type and stage of the patient's wound, to ensure effective wound treatments are used to expedite healing.

For more information on chronic wound diagnosis or other wound care services available, please call 1-866-KHS-HEAL.

Chronic Wound Types

While there are many types of wounds, some of the most common types and their causes are:

  • Infectious wounds: Whether it is bacterial, fungal or viral, if the cause of the infection is not treated with the proper medication, the wound will not heal properly in the expected time.
  • Ischemic wounds: Ischemia means that the wound area is not getting sufficient blood supply. Limiting the blood supply, and the oxygen and nutrients it carries, can delay the healing process or even prevent it.
  • Radiation poisoning wounds: Regardless of whether the source of radiation was therapeutic (gamma rays or X-rays) or accidental (exposure to radioactive materials from nuclear plant accidents or radioactive devices that detonate), excessive exposure to ionizing radiating materials can weaken the immune system, cause damage to exposed tissue and delay the healing time of all wounds.
  • Surgical wounds: Wounds caused by incisions made during surgery can progress to chronic wounds if the blood supply to the surgical area was accidentally damaged or if wound care was inadequate. Both can delay the healing time of a wound.
  • Ulcers (the most common type of chronic wounds):
    • Arterial ulcers: These can occur from hypertension, atherosclerosis (plugging) and thrombosis (clotting), where the reduced blood supply leads to an ischemic state.
    • Venous ulcers: These account for more than half of ulcer cases, especially in the lower limbs (mainly the legs) as associated with deep vein thrombosis, varicose veins and venous hypertension. Venous ulcers can lead to stasis, where the blood fails to circulate normally.
    • Diabetic ulcers: These are a common complication in uncontrolled diabetes mellitus, resulting in impaired immune function, ischemia (due to poor blood circulation) and neuropathy (nerve damage), which eventually lead to breakage of skin and ulceration.
    • Pressure ulcer: The constant pressure and friction resulting from body weight over a localized area for prolonged duration can lead to breakage of skin and ulceration (also known as bed sores); especially on the back and on the ankles and feet.

For more information on chronic wound diagnosis or other available wound care services, please call 1-866-KHS-HEAL.

Signs and Symptoms of Chronic Wounds

Maintaining your health means being aware of the signs and symptoms of the development of a chronic wound. Some of the signs and symptoms are:

  • Infectious wounds: These typically have a bad odor, pus drainage, debris (yellowish to greenish) or dead tissue, and ongoing symptoms of inflammation (fever, pain, redness, hotness and swelling).
  • Ischemic wounds: Usually the wound area will be pale and cold. There might also be a decrease in the hair growth and a weak pulse sensation in the area.
  • Radiation poisoning wounds: These can present with redness, blistering, itching, inflammation and other unspecified symptoms that include nausea, vomiting, abdominal pain and fever.
  • Surgical wounds: Typically occur at the site of a surgical incision, but instead of a clean appearance, the tissue around the incision appears red, hot, and swollen, which can be infected or inflamed.
  • Ulcers:
    • Arterial ulcers: Usually involve the full thickness of skin, having a punched out appearance with smooth edges and occasionally pain that subsides when the legs are lowered below the heart level. In some cases, ischemia is present (poor circulation to area).
    • Venous ulcers: The skin is usually shiny and smooth with minimal to no hair. These ulcers are superficial, shallow, and irregularly shaped with pain and edema. These can sometimes be associated with infection or inflammation.
    • Diabetic ulcers: These can be from neuropathic (secondary to nerve damage) origin, where the lack of sweat makes the skin dry and easy to crack and scale, forming calluses (accumulation of dead skin layers). The callused area, mostly occurring on the foot, can eventually break down and form an ulcer. Diabetic ulcers can also occur from neuropathy with ischemic origin; where the ulcer area is cool with no pulse, in addition to the other signs of ischemia described above.
  • Pressure Ulcers: These present with redness that doesn’t go away when pressed upon, and includes itching, blistering, hotness, swelling and discoloration of the area.

For more information on chronic wound diagnosis or other available wound care services, please call 1-866-KHS-HEAL.