Long-Term Care

Trainer’s tip: Pressure ulcer terminology

LTC Nursing Assistant Trainer, December 31, 2009

A pressure ulcer is any lesion caused by unrelieved pressure that results in damage to underlying tissue. Pressure ulcers usually occur over bony prominences and are staged to classify the degree of tissue damage observed. The following is a list of terms associated with pressure ulcers:

  • Debridement – Excision of devitalized tissue and foreign matter from a wound.
  • Eschar – Dead, devitalized tissue. A thick, coagulated crust or slough caused by pathologic tissue death. The eschar is commonly black but may be other colors; it is typically thick and leathery, and must be removed before healing can occur.
  • Granulation tissue – Moist pink/red tissue consisting of new blood vessels, connective tissue, fiber blasts, and inflammatory cells. This tissue fills an open wound when healing begins.
  • Necrosis – Pathologic tissue death resulting from irreversible damage.
  • Tunneling – A sinus tract. Tunnels are larger and easily observed; sinus tracts are small, with a narrower opening. These are pathways, courses, or tracts of tissue destruction extending in any direction from the surface or edge of the wound. They are dead spaces that increase the risk for abscess formation.
  • Undermining – May also be called rimming. These terms describe overhanging ulcer margins, commonly seen in shearing injuries. This condition is confined to the edges of the wound. The area of tissue destruction extends under intact skin along the wound margins. Can be distinguished from sinus tracts/tunneling because undermining involves a significant portion of the wound edge, whereas a sinus tract involves only a small portion of the wound edge and may extend deep into the wound.

This is an excerpt from HCPro’s book, The Long-Term Care Nursing Desk Reference, Second Edition, by Barbara Acello, MS, RN.

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