4.0 Classification of wounds

A wound can be defined as a breakdown in the protective function of the skin and can be divided into acute and chronic wounds. Acute wounds tend to heal in an uncomplicated way following the normal stages of wound healing. Chronic wounds tend to be full thickness and because the process of healing has become disrupted they take longer to heal. Taking longer to heal puts these chronic wounds at risk of becoming infected.

Both acute and chronic wounds differ in appearance (morphology) and causes (aetiology). Both wounds can appear as follows –

Appearance (morphology)

• Clean granulating wounds
• Wounds with necrotic tissue
• Epithelialising wounds
• Sloughy wounds
• Wounds with hyper granulation
• Wounds with excessive exudate
• Wounds where the granulation looks dull
• Surgical wounds

Cause (aetiology)

• Ulcers can be related to changes in vessels. It may be arterial, venous or lymphatic disease that has caused the ulceration
• Neuropathic ulcers related to diabetes
• Surgical wounds
• Burns
• Trauma wounds
• Pressure ulcers
• Fungating tumours
• Radiotherapy burns
• Fistulas
• Dermatological cause
• Self-inflicted wounds

Wound bed with fibrin coating

Wound with necrotic tissue ( yellowed necrosis)

Wound with bacterial imbalance

Wound with hypergranulation tissue

Arterial wounds: can be due to blood vessel disorders related to arterial, venous or lymphatic problems

Trauma injuries: injuries, operations and heat related wounds are acute trauma wounds

Pressure wounds: wounds caused by pressure and friction

Pressure wounds: pressure wound with blackening and yellowing necrosis

Cancer wound

Radiation injury to the skin

Granulation tissue

Arterial ulcer

Bacterial biofilm

Dry necrosis

Exudative ulcer

Hypertensive ulcer

Ischemia in a diabetic patient

Ischemic ulcer

Necrotising fascitis

Neuropathic ulcer in a diabetic foot

Surgical wound

Venous ulcer I

Venous ulcer II