Wound Care

Compromised skin grafts and skin flaps stand for a problem involving inadequate oxygen supply to tissue. Skin grafts typically survive as oxygen disperses into them from the original wound bed. Skin grafts can partially or fully fail when there is not enough oxygen supplied. 

There are a few types of skin grafts which are: full-thickness grafts where all the layers of skin are used, split-thickness grafts in which only the top layers and some of the deep layers are used, as well as pedicle grafts where part of the skin remains to the donor site. Factors such as age, nutritional status, smoking, and previous radiation result in an erratic pattern of blood flow to the skin.

Neuropathy can contribute to the formation of a diabetic foot ulcer. If left untreated, diabetic foot ulcers can progress to severe infection or gangrene that might require amputation. In fact, diabetic ulcers are one of the most common causes of foot amputation.

As such, it is important for patients with diabetes to be fully aware of foot-related problems and the potential for long-term disability. The good news is that through good foot care, and by regulating blood glucose levels, diabetics can decrease the chance of developing diabetic foot ulcers.

To distinguish a minor burn from a serious burn, the first step is to determine the extent of damage to body tissues. The three burn classifications of first-degree burn, second-degree burn and third-degree burn will help you determine emergency care.

Osteomyelitis is an infection in a bone. Infections can reach a bone by traveling through the bloodstream or spreading from nearby tissue. Osteomyelitis can also begin in the bone itself if an injury exposes the bone to germs.

In children, osteomyelitis most commonly affects the long bones of the legs and upper arm, while adults are more likely to develop osteomyelitis in the bones that make up the spine (vertebrae). People who have diabetes may develop osteomyelitis in their feet if they have foot ulcers.

Once considered an incurable condition, osteomyelitis can be successfully treated today. Most people require surgery to remove parts of the bone that have died — followed by strong antibiotics, often delivered intravenously, typically for at least six weeks. Source: themayoclinic.org

Osteoradionecrosis (ORN) is a problem with bone healing that can occur in people who received high doses of radiation, particularly to the jaw. This complication can occur after dental surgery or extraction of teeth. High doses of radiation can decrease the bone’s blood supply. If this happens, the bone gets less oxygen than it needs, resulting in the death (necrosis) of bone tissue. The most commonly affected bone is the jawbone (mandible).

A pressure ulcer, also known as a bedsore or decubitus ulcer, is a wound of the skin caused by prolonged, unrelieved pressure to that area. Pressure ulcers occur most frequently around bony prominences such as the tailbone, hips, heels, ankles and elbows.

You will have a surgical wound after any type of operation that involves making a cut into your skin, including minor procedures, as well as those done by surgeons. For simplicity, we will refer to surgeons throughout this factsheet.

The position and size of the cut your surgeon makes will depend on the type of operation and surgery you have. For example, if you have keyhole (laparoscopic) surgery, your surgeon will make small cuts to your skin, which will be closed with stitches, clips or skin glue to bring the skin edges together to heal.

Traumatic wounds are typically defined as cuts, lacerations or puncture wounds which have caused damage to both the skin and underlying tissues. Acute wounds, cut wounds and penetrating wounds are the three categories that make up traumatic wounds. An acute wound occurs when the skin has been ripped or torn and has a jagged appearance. An acute wound typically contains foreign bodies such as gravel, glass, metal or sand.

With acute traumatic wounds, it is not uncommon for layers of tissue to be easily visible along the inside of the cut. A traumatic cut wound is the result of something sharp penetrating the skin and the underlying subcutaneous tissues. Penetrating wounds, however, are considered the deepest and most severe of all traumatic wounds, because they often occur as the result of being stabbed or sustaining a gunshot wound.

A venous stasis ulcer, also known as a venous insufficiency ulcer, means that there is an impairment or lack of venous blood flow to an area of the skin. These ulcers occur in the lower legs, between the knee and the ankle. The most common place for them to develop is around the ankle.

In most cases, there is a change in the color of the skin before it actually opens (ulcerates), like a red spot or a black and blue bruising. Due to the lack of circulation, which provides the essential nutrients for the skin to survive, the skin begins to die in this spot and opens (ulcerates.) These wounds are typically shallow (do not get very deep.) They are often irregular in shape and tend to elongate (like a run in stockings.) Left untreated, they do not get better and will get worse.

Ulcers of the lower extremities, particularly in individuals older than 65 years, are a common cause for visits to the podiatrist, wound care specialist, primary care physician, vascular surgeon, or dermatologist.

The great majority of vascular ulcers are chronic or recurrent. They cause a considerable amount of morbidity among patients with peripheral vascular disease, including work incapacity. The care of chronic vascular ulcers places a significant burden on the patient and the health care system. Additionally, these nonhealing ulcers place the patient at much higher risk for lower extremity amputation