Triangle of Wound Assessment Made Easy: Revisited
Journal Title: Dermatology – Open Journal - Year 2016, Vol 1, Issue 3
Abstract
Objective: We have provided evidence based critical review of the “Triangle of wound assessment made easy.Background: Wound assessment is a vital step in managing patients with acute and chronic wounds in daily clinical practice. The natural progression of most wounds is to heal naturally in a coherent and timely manner, although a minority of wounds will fail to heal. The aim of treating recalcitrant wounds that fail to heal is to control symptoms and delay or prevent complications. One vital step in managing wounds is proper and comprehensive evidence based wound assessment. Methods: We have carried out literature review including systemic reviews, met analysis pertaining wound assessment including international guidelines. Results: We have found few gaps in the proposed “Triangle of wound assessment made easy”which have been addressed accordingly. We have revised the concept of (infection) i.e. “raised white blood cell (WBC) count as a sign of infection” and argued that in up to one-half of patients,even with severe diabetic foot infection raised temperature, WBC count, or sedimentation rate are absent. A second point of concern is the omission of “probing to bone sign” in the diagnostic criteria of local signs of infection. Recent clinical studies have demonstrated that in the presence of a clinically infected ulcer, a positive Probe-to-Bone Test (PTB) test is highly suggestive of osteomyelitis, but a negative test does not rule out the diagnosis; conversely, in the situation of an apparently uninfected foot wound, a positive PTB test is not specific for osteomyelitis, but this diagnosis is unlikely if the PTB test is negative. Lastly, the authors have suggested reducing wound bio burden/manage infection through the use of topical antimicrobial therapy-including antiseptic agents. Topical antiseptics have inconclusive proof of efficacy in various etiology wounds and concern remain regarding their residual cytotoxicity when in contact with newly forming granulating tissues especially when highly concentrated rinse solutions is the common practice in developing countries of the world. Conclusion: On the basis of these analysis, we propose revising the “Triangle of wound assessment made easy” in order to address these gaps and maximize its utility in clinical practice.
Authors and Affiliations
Hashim Mohamed
Keywords
Related Articles
- EP ID EP550746
- DOI 10.17140/DRMTOJ-1-114
- Views 160
- Downloads 0
Natural Honey in the Management of Thermal Burn of the Foot in a Type 2 Diabetic Patient: A Case Report
We report the case of a 58-year old male with type 2 diabetes who was admitted to Um-Gwailinah Health Center with a second degree burn involving his big hallux, 4th and 5th toe and the bases of 2nd, 3rd, 4th and 5th toe...
Multiple Cysts Localized to the Vulva: A Case Report
Epidermal, or inclusion cysts, are the commonest type of epithelial cysts of the skin. These are keratin-containing cysts lined with stratified squamous epithelium. Multiple vulvar cysts are rarely reported. A 61-year-ol...
Emerging Age of Opportunity for More Effective Treatments in Atopic Dermatitis
Atopic dermatitis (AD) is a chronic inflammatory disease characterized by widespread lesions, which manifest as erythematous areas with crusting and/or scaling, oozing, excoriations, and lichenification. Additionally, pr...
Spongiosis: A Short Review
Spongiosis is the hallmark of eczematous dermatitis. The mechanism underlying it is somewhat complex and is not fully understood up till now. Many factors interplay to produce spongiosis. One of these factors is Fas rece...
Analysis of Mortality in a Dermatological Affections Referral Center in Sub-Saharan Africa, Abidjan, République de Côte d'Ivoire
Objectives:To document patients who died in Dermatology Department at University Teaching Hospital (UTH) of Treichville; describe epidemiological aspects; indicate the various dermatological diseases associated; specify...