Clinical assessment of wounds
- David G Armstrong, DPM, MD, PhD
David G Armstrong, DPM, MD, PhD
- Professor of Surgery and Director
- Southwestern Academic Limb Salvage Alliance (SALSA)
- Keck School of Medicine, University of Southern California
- Andrew J Meyr, DPM
Andrew J Meyr, DPM
- Clinical Associate Professor
- Temple University School of Podiatric Medicine
- Section Editors
- Hilary Sanfey, MD
Hilary Sanfey, MD
- Section Editor — General Surgical Principles
- Professor of Surgery
- SIU School of Medicine
- John F Eidt, MD
John F Eidt, MD
- Section Editor — Vascular and Endovascular Surgery
- Professor of Surgery, Texas A&M Health Science Center
- Vice Chair of Vascular Surgical Services, Baylor Heart and Vascular Hospital at Dallas
- Joseph L Mills, Sr, MD
Joseph L Mills, Sr, MD
- Section Editor — Vascular and Endovascular Surgery
- Professor and Chief
- Division of Vascular Surgery and Endovascular Therapy
- Baylor College of Medicine
- Russell S Berman, MD
Russell S Berman, MD
- Section Editor — Skin and Soft Tissue Surgery
- Chief of Surgical Oncology
- New York University Langone Medical Center
A wound represents a disruption of the normal structure and function of the skin and soft tissue structure and may be due to a variety of mechanisms and etiologies . The clinical assessment of wounds begins with a determination of whether the wound is acute or chronic in nature. Acute wounds are those in which healing is anticipated to progress through an orderly physiologic sequence of inflammation, proliferation, and maturation [2,3]. A chronic wound may be defined as one that is physiologically impaired because of inadequate angiogenesis, impaired innervation, or impaired cellular migration, among other reasons . Examples of chronic wounds include ischemic ulcers, venous ulcers, diabetic foot ulcers, and infected wounds, including surgical site infections [5,6]. Healed chronic wounds, particularly diabetic foot ulcers, should be considered "wounds in remission" and at very high risk for recurrence.
The clinical assessment of acute and chronic wounds, including differentiating the most common chronic ulcers, will be reviewed. Treatment of chronic wounds is discussed separately.
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