Glossary of Wound Care Terms

ABSCESS - Localized collection of pus in any part of the body. An acute abscess is characterized by inflammation , pain and possible increase in temperature.

ACTIVE HEALING - The use of wound dressings to optimize the healing environment.

ACUTE- Having a rapid onset and a short course; the opposite of chronic. A surgical incision is an example of an acute wound.

AEROBE - A microorganism which lives and grows in the presence of oxygen. Aerobes are commonly found on the skin.

AMBULATORY- Able to walk; not confined to a wheelchair. Patients who are ambulatory have a decreased risk for skin breakdown.

ANAEROBE - A microorganism which lives and grows in the absence of oxygen. The presence of anaerobes in a wound is a potential problem with gas impermeable dressings.

ANGIOGENESIS - Development of capillaries that provide nutrients to regenerating tissue.  The process of angiogenesis gives rise to the beefy, red nature of granulation tissue.

ANTIBACTERIAL - An agent that kills or inhibits the growth of bacteria.  Certain antibacterial agents, such as iodine or CHG, are toxic to blood components.

ARTERIAL ULCER - Arterial ulcers are extremity ulcerations that result from complete or partial blockage of the arteries, also known as arterial insufficiency. Because arteries are blocked, adequate circulation fails to reach certain parts of the body. The extremities, such as the hands and feet, often suffer from arterial insufficiency, as blockage in the legs or arms impedes blood flow. The most common location of arterial ulcers is at or below the ankle, between the toes, or over bony prominences.

ASEPTIC - Free of microorganisms; sterile.

ATROPHY BLANCHE - White, smooth flat scars with focal dilated capillaries

AUTO-DEBRIDEMENT - Disintegration or liquification of nonviable tissue by leukocytes and enzymes; autolysis.

BACTERICIDAL-  A property  of an agent which destroys (kills) bacteria.

BACTERIOSTATIC - Inhibiting or retarding bacterial growth.

BIOBURDEN - The sum total of microbes capable of causing colonization and/or infection.

BLANCHING - To become white with pressure; maximum pallor. Blanching will occur in an area where more than 20mm of external pressure  has been introduced.

BLISTER - a collection of fluid below the epidermis.

BURN - Tissue injury resulting from excessive exposure to thermal, chemical, electrical, or radioactive agents.

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CAPILLARY - Minute blood vessels that connect small arteries with small veins; gives granulation tissue its characteristic red color and provides nutrients to regenerating tissue.

CELL MIGRATION - Movement of cells in the repair process.

CELLULITIS - Inflammation of loose connective tissue characterized by redness, swelling and tenderness.

CHEMOTAXIS - The attraction of leukocytes (white blood cells) to a specific part of the body by chemical stimuli.

CHRONIC - A disease of slow progression and low continuance. Pressure sores and leg ulcers are examples of chronic wounds.

CHRONIC WOUND - wound that has failed to proceed through an orderly and timely process to produce anatomic and functional integrity, or proceed through the repair process without establishing a sustained anatomic and functional result.

CLINICAL INFECTION - The presence of microorganisms in a quantity that overwhelms the host’s defenses; generally accompanied by fever, redness, swelling pain and heat. Wounds that are colonized with microorganisms will not necessarily result in a clinical infection.

COLLAGEN - Main supportive protein of skin, tendon, bone, cartilage and connective tissue. Collagen is synthesized from fibroblasts and replaces lost dermis.

COLONIZATION - Refers to a site of reproduction of microorganisms. Wounds containing less than 10⁵ colony-forming units are considered to be colonized rather than infected.

COMPRESSION DRESSING - Promotes venous circulation in the management of venous stasis ulcers.

COMPROMISED - Refers to reddened or broken skin due to some underlying cause. Skin that has been compromised by pressure first appears as a reddened area.

CONTAMINATE - To become soiled by contact; the introduction of organisms into a wound. Most wounds are contaminated, although, few are infected.

CONTRACTION - The process by which full thickness wounds are drawn  together along the tension lines of the skin; proceeds in tandem with granulation tissue growth. The edges of the wound are brought together through the process of contraction.

CONTRA-INDICATED - Circumstances that indicate the inappropriateness of a given treatment.

CUTANEOUS - Pertaining to the skin; synonyms include dermal and integumentary.

DEBRIDEMENT - The removal of foreign material and nonviable tissue from a wound. Types include surgical, mechanical, enzymatic and autolytic. Wound healing can occur only after the debridement process is complete.

DEBRIS - Remains of damaged cells or tissue.

DECUBITIS - A misnomer for a pressure sore. Decubitis is an outdated term for pressure injuries.

DEFORMITY - An unnatural alteration in the natural form of a part of the body.

DENUDE - Erosion of the epidermis.  Highly acidic or alkaline body fluids may denude healthy skin.

DEPENDENT RUBOR - Congestion of arterial system demonstrated by bright red (ruby) color when legs are dependent and white color when legs are elevated. Symptomatic of arterial disease.

DERMAL WOUND - Loss of skin integrity; may be superficial or deep. Dermal wounds include pressure sores and leg ulcers.

DERMAL REPAIR - The regeneration of the dermis. Dermal repair is a function of granulation tissue growth and wound contraction.

DERMATITIS - Inflammation of the skin, usually described by the presumed cause.

DERMIS - The inner layer of skin in which hair follicles and sweat glands originate. The dermis lies between the epidermis and subcutaneous tissue.

DESICCATION - The process of drying; an undesirable condition for wound healing. Desiccation is enhanced by the use of wet-to-dry gauze dressings.

DIABETIC ULCER - An ulcer that develops due to diabetic risk factors. Diabetes affects circulation as well as the nerve endings in the feet. As a result, many diabetics suffer reduced circulation and loss of sensation in their feet. The loss of sensation is dangerous, because diabetics are unable to feel rubbing, pinching or other pain that could cause a wound to develop on the foot. Lack of circulation to the feet makes it very difficult for a wound to heal. Risk factors for developing a diabetic foot ulcer include loss of sensation or peripheral neuropathy, structural foot deformity, infection, and decreased circulation.

ECCHYMOTIC - Purplish patch >3 mm diameter caused by extravasation of blood into the skin.

ECZEMA - A superficial inflammatory process of the skin
often characterized by redness, itching, weeping, oozing, and crusting.

EDEMA - The presence of abnormally large amounts of fluid in the interstitial space. Poor circulation may lead to edema of lower extremities.

ENZYMES - Catalysts for biochemical reactions that are capable of breaking down tissue.  Enzyme products may be used to debride necrotic tissue.

EPIDERMIS - The outer cellular layer of skin. The epidermis remains intact in a Stage 1 pressure injury.

EPITHELIALIZATION - Cellular regeneration of the epidermis across the wound surface.

ERYTHEMA- Reddened skin as a result of  vasodilatation. Erythema is seen during the early stages of wound healing.

ESCHAR - Thick leathery necrotic tissue; devitalized tissue. Eschar forms on wounds that are exposed to the environment.

ETIOLOGY - The underlying cause of a disease or condition. Unrelieved pressure is the etiology of many dermal ulcers.

EXCORIATION - Abrasion of the epidermis.

EXUDATE - Accumulation of fluid in a wound. May contain serum, cellular debris, bacteria and leukocytes.

EXUDATE ABSORBING COMPOUNDS - Hydrophillic pastes and powders that absorb large amounts of wound fluid and bacteria. Exudate absorbing compounds are often difficult to remove from the wound bed without trauma.

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FIBRIN - A protein deposited as a fine interlacing filament which entangles red and white blood cells. Excessive fibrin deposits in the wound lead to scarring.

FIBROBLAST - A cell from which connective tissue is developed. Fibroblasts are the critical cells for granulation tissue growth.

FIBROTIC - An abnormal formation of fibrous tissue.

FRICTION-  The action of skin rubbing against another surface. When patients are moved incorrectly, friction may lead to skin breakdown.

FULL-THICKNESS - Tissue injury extending through the dermis to involve the subcutaneous layer; may also involve muscle, tendon and/or bone.

GRANULATION - The growth of small blood vessels and connective tissue in a full thickness wound. Granulation tissue in the wound base has a beefy red, moist, cobblestone appearance.

GRANULOCYTE - A polymorphonuclear leukocyte; a type of white blood cell. Granulocytes phagocytize cellular debris and bacteria.

GROWTH FACTOR - A therapeutic agent administered to the wound bed at a specific stage of repair to enhance healing.

HAIR FOLLICLE - An invagination of the epidermis which holds the hair root. Hair follicles give rise to new epithelial cells after injury to the epidermis.

HEMOSIDERIN STAINING - Hemoglobin deposited in tissues. Appears as brownish patches. Symptomatic of venous disease.

HYDRATION - Refers to an individual’s total fluid volume; includes fluid taken orally, intravenously and/or through a feeding tube. Also refers to the maintenance of a moist wound bed.

HYDROCOLLOID DRESSING -  An adhesive gelatin/pectin mass that absorbs wound exudate; generally does not allow for gaseous exchange.

HYDROGEL DRESSING - A polymer that consists mainly of water, Although non-adhesive and absorptive, hydrogels are permeable to bacteria. Because they are cool to the touch, hydrogel dressings are soothing to broken skin.

HYDROPHILIC - Attracts moisture.

HYDROPHOBIC - Repels moisture.

HYPEREMIA - Presence of excess blood in the vessels; engorgement.  Hyperemia may occur if a leg ulcer is dressed to tightly.

HYPERGRANULATED - Overgrowth of granulation tissue

HYPERKERATOTIC - Callus-like tissue containing keratin (a component of the epidermis)

IMMUNOSUPPRESSION - An alteration in the immune response. Patients with immunosuppression have a poor potential for wound healing.

INDURATION - An area of hardened tissue that may accompany venous insufficiency; may also be noted in the presence of a true clinical infection. Wound edges with induration feel hard to the touch.

INFLAMMATION - Defensive reaction to tissue injury that facilitates physiologic clean-up;  involves increased blood flow and capillary permeability. Accompanied by increased redness, swelling, pain and heat in the affected area. Inflammation is the first phase of wound healing.

INSULATION - The protection of the wound bed with a non-conducting medium to prevent the transfer of heat. Insulation of the wound bed enhances the process of cellular regeneration.

ISCHEMIA - Local deficiency of blood supply as a result of obstruction. Ischemia occurs when more than 20mm of pressure is applied to an area of the body.

LESION - A broad term referring to wounds or sores. 

LEUKOCYTES - White blood cells that act as scavengers and help combat infection; includes macrophages, neutrophils and monocytes.

LIPODERMATOSCLEROSIS - an induration and erythematous hyperpigmentationof the leg.

MACERATION - Softening of fluids by soaking in fluids. Maceration will occur when the skin is in contact with excess exudate for a prolonged time period.

MACROPHAGE - A type of leukocyte which has the ability to destroy bacteria and devitalized tissue. Macrophages are white blood cells which protect the body and are easily destroyed by antiseptic agents.

MEDICAID - A state-run program which provides payment for inpatient, outpatient and physician services for those receiving federally supported financial assistance. Medicaid reimbursement for wound dressings varies greatly from state to state and year to year.

MEDICARE - The federal program of health insurance for persons over 65 years of age and some disabled persons of any age.  Inpatient wound dressings are covered by Medicare Part A; outpatient wound dressings may be covered by Medicare Part B.

MOISTURE VAPOR  TRANSMISSION RATE (MVTR) - The rate at which moisture vapor is passed  from the wound bed through a semi-permeable matrix.  The relative speed at which a thin film manages exudate is a function of its moisture vapor transmission rate.

NECROTIC - Refers to the death of tissue in a small, localized area.

NEUTROPHIL - A leukocyte which destroys bacteria and devitalized tissue; also called macrophages. Neutrophils are critical to the process of phagocytosis.

NOSOCOMIAL - Infection acquired in a hospital. Thorough hand-washing is considered to be the first line of defense against nosocomial wound infections.

OCCLUSIVE - Refers to a class of dressings that maintain a moist wound bed including hydrocolloids, foams, hydrogels and calcium alginate dressings; vary in terms of permeability to gases and bacteria.

PARTIAL THICKNESS - Injury extending into the dermis. Traumatic lacerations and stage II pressure sores are two examples of partial-thickness wounds,

PASSIVE HEALING - The use of dressings to simply cover a wound and absorb exudate. Traditional gauze dressings are an example of passive healing.

PATHOGEN - Any disease-producing agent or microorganism.

PERIPHERAL VASCULAR DISEASE (PVD) - Alterations in the arteries and veins of the extremities; those conditions which interfere with adequate flow of blood to or from the extremities. Peripheral vascular disease broadly describes the underlying pathology of venous stasis ulcers and arterial ulcers.

PHAGOCYTE - Cells having the ability to ingest and destroy particulate substances. Phagocytes are easily destroyed by many antimicrobial agents.

PLATELET - Cells which serve to clot the blood. Platelets and white blood cells infiltrate the wound soon after tissue injury.

POLYURETHANE FILM DRESSINGS - The first occlusive dressings; also called thin films and transparent adhesive dressings.

POLYURETHANE  FOAM DRESSINGS - Occlusive dressings that serve to absorb/transmit moisture while providing thermal insulation without adhesion. 

PRESSURE SORE - An area of localized tissue damage caused by ischemia;  the result of unrelieved pressure.  Pressure sores are most common on the sacrum, hips and heels.

PRIMARY INTENTION - Refers to clean wounds closed with sutures. Surgical incisions are generally healed by primary intention.

PRURITIS - Severe itching.

PURULENT - Drainage that is thick, cloudy, yellow or tan in appearance. It contains leukocytes, bacteria, and dead cells.

PSORIASIS - A common, genectically-determined dermatitis consisting of pink or dull red lesions covered by silvery scaling.

PUS - Thick fluid that contains leukocytes, bacteria and cellular debris; generally indicative of infection.

PUSTULES - Small elevation of skin filled with pus.

PYOGENIC - The presence of microorganisms that form pus. Microorganisms that cause pyogenic reactions in wounds include Staphylocooous aureus, Streptococcus pyogenes, and Pseudomonas aeruginosa.

RESURFACING - The combined processes of epithelialization and contraction. Occlusive dressing therapy enhances the process of epithelial resurfacing.

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SANGUINEOUS - bloody drainage.

SCAB - Dried exudate. A scab forms when wound exudate interacts with the environment.

SCAR - Mark left in skin by healing of a wound, sore, or injurybecause of replacement of the injured tissue with connective tissue.

SECONDARY INFECTION - Infection arising during the process of wound healing rather than from the injury itself. Urine and feces are potential sources of secondary infection in sacral wounds.

SECONDARY INTENTION - Refers to wounds that are sutured to the muscular layer only. Granulation tissue gradually fills the deficit from subcutaneous tissue upward.  Wounds that are considered to be contaminated and have significant tissue loss are often left to heal by secondary intention.

SEPSIS - The result of microorganisms and their toxins in the blood stream; requires treatment with systemic antibiotics. A grossly infected wound is a potential source of sepsis.

SEROSANGUINOUS - Containing both serum and blood (i.e. thin, watery, pale red to pink).

SEROUS - Resembling serum (i.e. thin, watery and clear).

SHEARING - A process that enables the tissue layers to slide against each other; results in disruption or angulation of blood vessels. When the head of the bed is elevated, patients gradually slide downward. Such action is a shearing force to the sacrum.

SILENT INFECTION - Wound infections that do not display clinical signs and symptoms. A silent infection is considered if all impediments to healing have been addressed and granulation tissue is not evident.

SINUS TRACT - Course or pathway that can extend in any direction from the wound surface. It results in dead space that could potentially form an abcess. A sinus tract ends at a bony prominence and should be measured with a rayon or alginate swab.

SKIN TEAR - Traumatic wound defined as a separation of the epidermis and dermis from underlying structures as a result of friction or shearing.

SLOUGH - Loose, stringy necrotic tissue.

STRIKE THROUGH - Leakage of wound exudate from the edges of the primary dressing or the appearance of wound exudate through a gauze secondary dressing. Once strike-through has occurred, bacteria may enter the wound bed.

SURGICAL WOUND - Wound caused by surgery.

TENSILE STRENGTH - Refers to the maximum amount of pressure which can be applied to a wound without causing it to rupture; a function of the deposition of collagen. Wounds generally regain only 80% of their tensile strength.

TRAUMA - A physical injury caused by external force. Friction, shear and pressure are sources of trauma to healthy skin.

TRAUMATIC WOUND/INJURY - A traumatic wound is one that results from an unintentional injury or accident. Traumatic wounds are acute wounds. A number of wounds are considered traumatic wounds, including lacerations, cuts, scrapes and skin tears associated with an accident or trauma to the body.

TUNNELING - Tissue destruction underlying intact skin along wound margins. Indicate area of undermining on drawing. Measured by probing gently with rayon or alginate swab .

UNDERMINING - Separation of dermis and epidermis from the subcutaneous layer.

VARICOSITIES - swollen, twisted veins.

VAVULAR INCOMPETENCE - Refers to damaged valves in the perforator veins of the legs; results in poor venous return to the heart. Valvular incompetence is the underlying pathology of venous stasis ulcers.

VAPOR - Gaseous state of any substance.

VAPOR PERMEABLE - Allows the exchange of gases.

VASCULITIS - Inflammation of a blood or lymph vessel.

VENOUS STASIS - Stagnation of the normal flow of blood from the lower extremities to the heart due to valvular incompetence; also called venous pooling, venous congestion and venous hypertension. Venous stasis ulcers account for 95% of all leg ulcers.  

VENOUS INSUFFICIENCY - also called venous stasis - Stagnation of the normal flow of blood from the lower extremities to the heart due to valvular incompetence; also called venous pooling, venous congestion and venous hypertension. Venous insufficiency ulcers account for 95% of all leg ulcers.

VENOUS LEG ULCERS - Venous leg ulcers are shallow, irregular-shaped ulcers that often appear beefy and red. Typically, they are located below the knee, usually on the insides of the legs just above the ankles, however, they can occur almost anywhere on the lower leg. Venous leg ulcers are related to chronic venous insufficiency, a condition in which the veins in the leg are inadequate at pumping blood back towards the heart. As a result, fluid and blood products leak through the vessel walls into the surrounding tissue.

VIABLE TISSUE - Refers to healthy tissue; the opposite of necrotic tissue. Viable tissue appears as pink/ red tissue with a granular appearance.

WOUND BASE – Uppermost viable tissue layer of a wound; may be covered with slough or eschar.

WOUND MARGIN – Rim or border of wound. 

WOUND REPAIR – Healing process. Partial thickness injury involves epithelialization; full-thickness injury involves contraction, granulation and epithelialization.

YEAST - unicellular fungi. Presents on the skin as raised reddened patches with satellites.

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