Undermining is measured by the use of the clock hand positions. For example, you might use words like jagged, red, puffy, or oozing to describe the wound. Not only does it provide objective data to confirm wound progress, but it can also serve to alert clinicians about wound deterioration.1 Wound description and documentation also enhances communication among healthcare providers, patients, and care settings.1,2 Assessment of wounds is important because several clinical characteristics, such as new o… Ideal for packing deep, undermining or tunneling wounds. Pack the wound and undermined/tunneled areas with 1/4" Nu-Gauze saturated with Curasol Wound Hydrogel (amorphous). Measuring wounds. A B. Undermining is measured directly under the wound edge with a probe held almost parallel to the wound surface, stopping when resistance is felt. o Wound measurement guide. Clock terms are also used to identify the area of undermining. A cotton tipped applicator is tunneled under flaps of the wound and the distance is measured in centimeters. Measure the depth (C) at the deepest point of the wound. o Appropriate packing material. All major credit cards & PayPal accepted. Measure depth by inserting a cotton-tip applicator into the area of undermining and grasping the applicator where it meets the wound edge. Silk wound dressing helps eliminate scar tissue formation Sinus tracts are most often associated with surgical infections. A critical step in the wound assessment is measurement. About The Author Clock terms are often used to describe the position of the tunnel within the wound bed. Wounds are measured in centimeters using the clock method: Length is 12 to 6 o’clock (head to toe) with the width 3 to 9 o’clock (arm to arm). Image Credit: Medetec (http://www.medetec.co.uk/), Sources Foam and Wound Measurement Device Flexible to conform to wound shape and features a metric rule for easy measuring. http://www.ncnm.edu/images/CE/WCEI_outline.pdf. Learn about wound management in one of our online courses – Online Wound Care Certification Courses. This site uses Akismet to reduce spam. Without question, yes. A packing count of all dressings used to fill the wound space is to be done for any wound where the depth or the wound bed, undermining or sinus tract is 1 cm or greater. Tunneling generally occurs in one direction, whereas undermining may occur in one or more directions. Depth •Moisten a cotton-tipped applicator with normal saline solution or sterile water. What is the difference between undermining and tunneling of a wound? Then measure against the ruler, and document the measurement. The biggest difference between sinus tracts or tunneling and undermining is that tunneling and sinus tracts are unidirectional, whereas undermining may occur in more than one direction. Areas of undermining (extension of the wound under edges) and tunnelling (narrow passageway beneath intact skin) are measured by gently probing the NS moistened sterile applicator and compared to length on disposable rulers available in your wound care supply boxes. Write a brief description of the wound’s appearance to go along with the drawing. When underminingis present, the direction (using the clock method) and extent (measured in cms) should be documented. Join our “Where There’s a Wound, There’s a Way!™” fundraising campaign  Learn more, Copyright © 2009-2018 | WoundEducators.com | All Rights Reserved Wound Care Certification Courses Risk Free Guarantee | Terms and Policies | Sitemap. Measure depth by inserting a cotton-tip applicator into the area of undermining and grasping the applicator at the wound edge. Undermining is caused by erosion under the wound edges, resulting in a large wound with a small opening. o Adhesive strip e.g., sterile steri-strips or paper tape to secure a … To calculate the surface area the length is multiplied by the width which equals the surface area. The measurement of a wound, and the plotting of its size over time, is the only estimate that can be used to accurately predict wound healing. Progressing in a clockwise direction, document and measure the deepest sites all around the wound edges where undermining occurs. I Completed My Wound Care Course – Now What? As part of a thorough wound assessment, in addition to noting location and measuring size, the entire wound bed should be probed for the presence of tunneling and/or undermining.If you are unsure what tunneling and undermining are and how to recognize these phenomena, here’s an explanation of these terms and how to assess wounds … Because tunneling and undermining are not readily visible, all wounds must he thoroughly probed to identify the full extent of tissue destruction. By Laurie Swezey RN, BSN, CWOCN, CWS, FACCWS. The content is not intended to substitute manufacturer instructions. Blog, Wound Care Advisor WCA Posts navigation. There are many different wound cleansing solutions, and the best choice will be determined by several factors. Mark your measurements. The following presentation provides a brief overview of our program: https://woundeducators.com/course-preview/, We also recommend reading the following article: The Importance of Formal Accredited Certification in Wound Care: The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Adapted from VCHA Wound Care Assessment Tool (2009) (Please fill out ONE form per wound) Goal of Care: To Heal To Maintain To Monitor / Manage Wound Type / Etiology (if known) Pressure Venous 0 Arterial Diabetic Surgical 2 Intention Skin Tear Other Should pain management interventions be put in place before debriding a venous ulcer? How To Measure a Wound. © 2008-2020 Kestrel Health Information, Inc. All rights reserved. Reliable, consistent, comprehensive, and accurate wound description and documentation are essential components of a wound assessment. Tags: wound measurement, wound terms Categories: Wound Assessment and Documentation. Dumex® Measure It® Wound Measurement Kit, Sterile A very safe and accurate method of wound assessment. Gently measure deepest portion of the wound using a sterile cotton-tipped applicator or measurement device “straight in” (Figure 5) The depth is measured when the applicator shaft emerges at skin level. Wound Care Education Institute. Think of undermining like this: the wound is larger than the "hole" or entrance of the wound. 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. 31 Toe Head. Undermining is measured by inserting a probe under the wound edge directed almost parallel to the wound surface until resistance is felt. Expert panels shape of the fascial planes which results in dead space that has the potential abscess. Is when the edges have pulled away from the skin ’ s appearance to go along with wound. 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