CWOCN key terms

Localized damage to skin and underlying tissue, usually over a bony prominence, caused by sustained pressure often combined with shear. It may present as intact skin or an open ulcer and is staged to guide prevention and treatment.

A six-item risk assessment tool scoring sensory perception, moisture, activity, mobility, nutrition, and friction or shear. Lower total scores indicate higher risk for pressure injury, so prevention resources are targeted to those patients.

Intact or non-intact skin with a persistent deep purple or maroon area or a blood-filled blister, caused by pressure and shear damaging deeper tissue. It can worsen rapidly despite appropriate prevention and treatment.

Thick, leathery dead tissue that may be tan, brown, or black and clings firmly to the wound bed. It can hide underlying damage and is often removed before staging or healing can occur.

Soft, moist yellow or white dead tissue that loosely clings to the wound bed. It is common in healing wounds but may harbor bacteria and is sometimes mistaken for pus.

New healthy tissue that fills a healing wound, appearing red or pink, moist, and slightly bumpy like cobblestone. It contains new capillaries and collagen and shows the wound is progressing toward closure.

Wound edge tissue that has broken down beneath intact skin, creating a pocket that extends sideways under the wound margin. Clinicians gently probe with a swab and record depth and clock position.

A narrow channel or tract extending from the wound bed into surrounding tissue, sometimes reaching another opening. Depth and direction are measured with a sterile swab so packing and documentation are accurate.

Softening, whitening, and wrinkling of skin from prolonged moisture exposure, such as wound drainage or urine. It weakens the skin barrier and raises the risk of breakdown and infection.

Removal of dead tissue, debris, and bacteria from a wound by sharp, autolytic, enzymatic, mechanical, or biological methods. It lowers infection risk and exposes healthy tissue so healing can proceed.

A structured community of bacteria attached to a wound surface and surrounded by a protective matrix. It resists antibiotics and the immune system and is managed with repeated debridement plus antimicrobial dressings.

A sealed dressing connected to a pump that applies controlled suction to a wound, removing drainage and encouraging granulation. It requires adequate blood flow and is avoided in untreated infection or malignancy.

A ratio comparing systolic blood pressure at the ankle with the brachial artery, used to screen for peripheral arterial disease. It helps decide whether compression therapy is safe before treating a leg ulcer.

Controlled external pressure applied with bandages or stockings to reduce venous pooling and swelling, mainly for venous leg ulcers and lymphedema. Arterial circulation must be assessed before it is used.

Reducing or redistributing pressure on a wound or an at-risk foot using specialty footwear, casts, cushions, or repositioning schedules. It is essential for healing diabetic foot ulcers and preventing pressure injuries.

A surgically created opening on the abdomen that brings part of the bowel or urinary tract to the skin surface. It may be temporary or permanent, is red and moist, and lacks pain receptors.

A stoma formed from the large intestine, usually in the left lower abdomen, that produces formed or semi-formed stool. Output may be regulated with diet, fluids, or irrigation.

A stoma formed from the small intestine, usually in the right lower abdomen, that drains liquid to semi-liquid stool continuously. Output contains digestive enzymes that irritate skin and can cause dehydration.

A stoma made from a short piece of intestine that carries urine from the ureters to the abdominal surface after the bladder is removed or bypassed. Urine flows continuously into a pouch.

The stool, urine, or drainage that leaves a stoma and collects in the pouch. Its amount, consistency, color, and odor help identify problems such as dehydration, bleeding, or infection.

The adhesive disc of an ostomy pouching system that sticks to skin around the stoma and shields it from effluent. It is cut to fit the stoma and changed on a regular schedule.

The skin immediately surrounding a stoma, which should be intact and look like the rest of the abdomen. Redness, erosion, or pain usually indicates leakage or a poorly fitting pouching system.

A pouching system feature that curves inward toward the stoma to support a flush or retracted stoma and prevent leakage. Excessive convexity can cause pressure damage to the stoma or skin.

A bulge beside the stoma caused by intestine pushing through weakened abdominal muscle. It may complicate pouching and is managed with support belts, pouching changes, and sometimes surgery.

A stoma that has pulled back to or below the skin surface, making a secure pouch seal difficult. Convex products and careful sizing help prevent leakage and peristomal skin damage.

A gap where the stoma's mucosa has pulled away from the surrounding skin, leaving an open weeping area. It is managed by filling the defect and keeping the pouching system sealed.

A bowel management method that instills lukewarm water through the stoma to stimulate evacuation, usually for a sigmoid colostomy. It can create predictable, pouch-free periods for some people.

Urine leakage with activities that raise abdominal pressure, such as coughing, sneezing, laughing, or lifting, caused by weak pelvic support or sphincter function. It is not caused by bladder contractions.

Involuntary urine loss preceded by a sudden, strong urge to void, linked to involuntary bladder contractions. Care includes bladder training, urge suppression techniques, pelvic floor exercises, and sometimes medication.

Frequent small urine leaks from a bladder that never empties properly, often due to obstruction or a weak bladder muscle. A high post-void residual supports the diagnosis.

Urine loss that happens because mobility, thinking, environment, or access barriers keep a person from reaching a toilet in time, although the urinary tract works. Care focuses on access and routine.

The amount of urine left in the bladder right after voiding, measured by bladder scan or catheterization. A high residual suggests incomplete emptying and raises risk for infection and overflow leakage.

Emptying the bladder at set intervals with a thin single-use catheter passed through the urethra, then removed. It manages incomplete emptying while carrying less infection risk than an indwelling catheter.

A tube left in the bladder that drains urine continuously into a closed bag. Long-term use increases catheter-associated urinary tract infection risk, so the need is reviewed daily.

A structured program of repeated pelvic floor muscle contractions taught with correct technique and practiced regularly. It is first-line treatment for stress and mixed incontinence in many patients.

A behavioral program using a voiding schedule and gradually longer intervals between voids to reduce urgency and frequency. A bladder diary is used to set and adjust the schedule.

A record kept for several days of fluids taken, volumes voided, leakage episodes, urgency, and pad use. It reveals patterns that guide individualized continence treatment and measure progress.

Skin inflammation caused by prolonged contact with urine or stool, appearing as redness, erosion, burning, or discomfort in the perineal area. It is prevented with gentle cleansing and moisture barriers.

Involuntary loss of liquid or solid stool or gas. Causes include sphincter or nerve damage, diarrhea, and impaction; care begins with diet, bowel scheduling, and skin protection.

Involuntary bladder muscle contractions during filling that cause urgency and often urge incontinence. It is confirmed with urodynamic testing and treated with behavioral therapy, medication, or other interventions.