Before we look into the actual assessment process, it’s important to remember that effective wound management goes beyond the wound itself.
When caring for a patient with wounds – chronic or non-chronic – it always important to take a holistic approach. That means taking note of the patient’s overall medical history and health as well as the condition of the wound itself. If you need to refresh your knowledge of holistic wound management, visit the section here.
In a thorough assessment of the wound – and the gap between the wound and the dressing – you should consider:2
- how long has the patient had this wound?
- what is the wound’s aetiology (i.e. what caused it)?
- how is it healing? Do you see any signs of progress?
- what are the wound’s characteristics? Here you should look at:
- the wound’s depth, undermining, tunnelling and fistulas
- the underlying wound bed structure and topography
- the tissue quality. Are there signs of granulation or necrosis?
- the periwound (surrounding) skin and the wound edge
- the exudate, or fluid in the wound – its colour, consistency, odour and amount
If you notice that exudate is pooling, or if you believe that the exudate’s composition is preventing the wound from healing, your first priority should be to remove the excess exudate. Choosing the right wound dressing is the best way to do this. You can read more about how to do that here.
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