Wound Types

Wounds are caused by trauma or skin breakdown. Wounds are considered to be acute wounds if they are new. Wounds are considered to be chronic if they are more than 3-4 weeks old.    

Deep vein thrombosis is a serious healthcare problem that affects over 250,000 patients in the US each year.

Source: Gloviezki, Peter, ed. The Layman's Handbook of Venous Disorders. N.p.: American Venous Forum

 

Types of Wounds

Wounds can be open or closed. Open wounds have exposed body tissue in the base of the wound. Closed wounds have damage that occurs without exposing the underlying body tissue. Wounds can originate from external causes such as penetrating objects or blunt trauma, or internal causes such as immune, metabolic, and neurologic etiologies.

Open Wound Types

Penetrating wounds:

  • Puncture wounds: caused by an object that punctures and penetrates the skin (e.g. knife, splinter, needle, nail)
  • Surgical wounds and Incisions: wounds caused by clean, sharp objects such as a knife, razor, or piece of sharp glass
  • Thermal, chemical, or electrical burns
  • Bites and stings
  • Gunshot wounds or other high velocity projectile which penetrates the body (this may have one wound at site of entry and another at site of exit)

Blunt trauma wounds:

  • Abrasions: superficial wounds due to the top layer of skin being traumatically removed (e.g. fall or slide on a rough surface).
  • Lacerations: wounds that are linear and regular in shape from sharp cuts, to irregularly shaped tears from trauma.
  • Skin tears: can be chronic like a wound in the base of a skin fissure, or acute due to trauma and friction.

Closed Wound Types

  • Contusions: blunt trauma causing pressure damage to the skin and / or underlying tissues (includes bruises)
  • Blisters: fluid filled pockets under the skin
  • Seroma: a fluid filled area that develops under the skin or body tissue (commonly occur after blunt trauma or surgery)
  • Hematoma: a blood filled area that develops under the skin or body tissue (occur due to internal blood vessel damage to an artery or vein)
  • Crush injuries: can be caused by extreme forces, or lesser forces over a long period of time.   

Ulcers

Ulcers are lesions that wear down the skin or mucous membrane that can have various causes depending on their location. Ulcers are a gradual disturbance of tissues by an internal cause in that originate from an impaired immune system or nervous system. Cells require blood, oxygen, and nutrients and anything that reduces the supply of these requirements can lead to ulcer formation. The most common types of internally originating skin ulcers are diabetic foot ulcers, venous leg ulcers, and pressure ulcers.  

Skin ulcer types:

  • Pressure ulcer: injury that causes breakdown of the skin and often the underlying tissue as well. Pressure ulcers can range in severity from discolored skin areas to large open wounds that expose the underlying bone or muscle.
  • Diabetic Foot Ulcer (DFU): a major complication of diabetes that occurs when neuropathic (nerve) and vascular (blood vessel) complications of the disease cause altered or complete loss of feeling in the foot and/or leg. Pressure from shoes, cuts or any injury to the foot may go unnoticed causing a DFU.
  • Venous ulcer (VLU): an open sore that develops when the skin is broken and air or bacteria gets into the underlying tissues. VLUs are caused by venous disease; a disease of the veins of the leg. 
  • Ulcerative dermatitis: an ulcer due to a dermatological condition
  • Genital ulcer: painful, non-sexually acquired genital ulceration. 

1. Garner SE, Frantz RA et al, The validity of the clinical signs and symptoms used to identify localized chronic wound infection.  Wound Repair Regen. 2001, May-June; 9(3): 178-86.
 

Signs of Wound Infection

Wounds are not sterile and all open wounds have a certain amount of bacteria, but this does not mean the wound is infected. Normal healing can still occur. An infection occurs when the bacterial growth increases significantly. Call your doctor or nurse if you have signs of an infection.

Classic Signs of Infection

  • Increased pain around the wound bed
  • Redness or warmth
  • Fever /chills or other flu-like symptoms
  • Pus draining from the wound bed
  • Increasing odor from the wound
  • Increased firmness of skin or swelling around the wound bed

Secondary Signs of Infection

Not all infections start with the classic signs of infection. There are secondary signs and symptoms that signal a lower grade infection in the wound bed, which delays healing and may progress if untreated1

  • Increasing drainage from the wound bed
  • Delayed wound healing
  • Discoloration of the wound bed with it turning darker in color
  • Foul odor
  • Increased fragility of the wound bed
  • Wound breakdown /enlargement

Infections That Can Occur with Lymphedema or Venous Disease

  • Fungal Infections: the two most common places for fungal infections are between skin folds and between the toes. Skin folds can sometimes have moisture buildup from sweat. This can cause the skin to break down and lead to fungal growth.
  • Erysipelas (bacterial infections): a superficial infection of the inner layer of your skin. With this type of infection, you will notice redness, swelling and warmth that will come on quite quickly. You may also have fever and chills.
  • Cellulitis: an infection involving the deeper layers of your skin. Similar to Erysipelas, Cellulitis presents with redness, warmth and edema. These infections can be mild and respond to oral antibiotics, or severe and require more intensive treatment.
  • Lymphangitis: an inflammation of the lymph vessels. These infections generally occur when bacteria enters the body through an open wound or cut and travels into your lymphatic vessels. With lymphangitis, you will see red streaks on the skin. This infection requires immediate treatment with antibiotics.

To learn more about these infections and other conditions associated with lymphedema, visit LymphCareUSA.com.