What does undermining mean in wound care?

The edges of the wound should pull together easily; if not, undermining needs to be done. Undermining means cutting the fibrous septae that connect the skin to the underlying fascia, and generally this is accomplished by using the scalpel to cut the septi just beneath the dermis as shown here.

What stage is an undermining wound?

Stage IV – Full thickness skin loss with exposed bone, tendon or muscle. Slough or eschar may be present on some parts of the wound bed. Often include undermining and tunneling.

What is the difference between Slough and eschar?

There are two main types of necrotic tissue present in wounds: eschar and slough. Eschar presents as dry, thick, leathery tissue that is often tan, brown or black. Slough is characterized as being yellow, tan, green or brown in color and may be moist, loose and stringy in appearance.

What does tunneling in a wound mean?

A tunneling wound is a wound that’s progressed to form passageways underneath the surface of the skin. These tunnels can be short or long, shallow or deep, and can take twists and turns. Tunneling can occur in stage 3 and stage 4 pressure ulcers.

What causes wound undermining?

Wound undermining occurs when significant erosion occurs underneath the outwardly visible wound margins resulting in more extensive damage beneath the skin surface. Consequently, while the external wound might appear small, large areas of tissue loss will be detected beneath the surface when the opening is probed.

What does wound exudate look like?

Serosanguinous drainage is the most common type of exudate that is seen in wounds. It is thin, pink, and watery in presentation. Purulent drainage is milky, typically thicker in consistency, and can be gray, green, or yellow in appearance. If the fluid becomes very thick, this can be a sign of infection.

How do you know if a wound is tunneling?

Tunneling results in dead space that has the potential for abscess formation. To measure tunneling, a probe is gently inserted into the passageway until resistance is felt. The distance from the tip of the probe to the point at which the probe is level with the wound edge represents the depth of the tunnel.

Should I remove slough from wound?

Slough is necrotic tissue that needs to be removed from the wound for healing to take place. When referring to slough, some terms may be used interchangeably, fibrotic tissue or necrotic tissue most commonly.

Is Slough good or bad?

Slough harbors pathogenic organisms, increases the risk of infection, and impedes healing by keeping the wound in the inflammatory phase or state; therefore, debridement methods are warranted. Exposing viable tissue will expedite the healing progress.

How do you measure a tunneling wound?

To measure tunneling, insert the cotton tip application into the tunnel. Grab the applicator at the wound edge and measure it again the ruler. The clock method is also used as reference when documenting the location of the tunnel.

What causes undermining and tunneling?

Causes/Risk Factors The risk factors for undermined wounds include: Patients with slow-healing ulcers (pressure or neuropathic) Wound site infection. Repeat trauma, exposure to shear forces at the wound site.

How to tell the difference between undermining and tunneling?

Undermining is less extensive, while tunneling penetrates more deeply into tissue. Probe the perimeter of the wound gently to determine the extent of penetration. Determine whether or not the wound is infected and what the causative organism is.

What causes tunneling and undermining in a wound?

The same factors that cause tunneling in wounds – infection, shear force, wound dehydration, and improper care – may also cause undermining. Treatment for undermining wounds is also similar to the treatment for tunneling wounds.

What’s the difference between a tunnel and a hole?

Length of tunnel:Undermining is when a wound diameter is wider at its base (deep in the wound) than at the wound’s skin edge. For example, the hole in the skin may be

How are an iceberg and a tunneling wound similar?

Undermining and tunneling wounds are similar to icebergs in that they are all much bigger than what they appear on the surface. Tunneling and undermining wounds are similar to one another, but they do have slight differences. This lesson will describe the similarities and differences between tunneling and undermining wounds.