WCC key terms

The thin outer layer of skin that acts as the body's first barrier against water loss, bacteria, and injury. It contains no blood vessels and heals by regeneration rather than by scarring.

The thicker layer beneath the epidermis, made of collagen, elastin, blood vessels, nerves, and glands. It gives skin strength and elasticity, and wounds that reach it heal with scar tissue.

The fatty layer under the dermis that contains fat, connective tissue, and larger blood vessels. It cushions, insulates, and stores energy, and pressure injuries extending into it are staged as deep injuries.

The first response to injury, in which blood vessels narrow and platelets form a clot to stop bleeding. The clot also releases signals that begin the rest of the healing cascade.

The early healing phase in which blood vessels widen and white blood cells clear bacteria and debris from the wound. Redness, warmth, swelling, and pain are expected during this stage.

The healing phase in which new tissue fills the wound. Fibroblasts build collagen, new capillaries form, and epidermal cells migrate across the surface to begin closing it.

The final healing phase, lasting months to years, in which collagen is rearranged and excess is removed. Scar strength rises over time but never returns to the strength of uninjured skin.

Red, moist, pebbly tissue made of new capillaries and collagen that fills an open wound from the base up. It signals healing in progress and bleeds easily when disturbed.

The movement and multiplication of epidermal cells across the wound surface to close it. It proceeds best over a clean, moist bed and is delayed by crusting, dryness, or heavy bioburden.

The main structural protein of skin, produced by fibroblasts, that gives tissue its tensile strength. In chronic wounds, breakdown outpaces production, which slows closure.

Softening and whitening of skin caused by prolonged moisture exposure, often from wound fluid trapped under a dressing. It weakens skin, can enlarge the wound, and is managed with absorbent dressings and skin barriers.

A pocket of tissue loss that extends under intact skin at the wound edge, roughly parallel to the surface. It is found by gentle probing and documented by clock position and depth.

A narrow passage extending from the wound into deeper tissue. Like undermining, it is explored with a soft probe and described by its location and depth so change can be tracked.

Recording the greatest length head-to-toe, the greatest width side-to-side, and the depth, all in centimeters. Using the same technique and units each time allows healing to be tracked reliably.

A six-item risk tool scoring sensory perception, moisture, activity, mobility, nutrition, and friction or shear. Scores range from 6 to 23, and lower scores mean higher pressure injury risk and prompt a prevention plan.

Localized damage to skin and underlying tissue, usually over a bony prominence, caused by pressure or pressure combined with shear. Staging is based on the tissue visible, not on how deep the damage is thought to be.

Intact or damaged skin with a persistent deep purple or maroon area, or a blood-filled blister, reflecting damage to deeper tissue. It may worsen and reveal more extensive injury over days.

Skin damage caused by equipment such as oxygen tubing, splints, masks, or catheters pressing against the skin. It is staged like other pressure injuries and prevented by padding and repositioning devices.

A force that slides layers of tissue against one another, as when a patient slides down in bed. It stretches and tears small vessels and tissue and often acts together with pressure over the sacrum.

Removing or spreading out pressure on a body area so that blood can flow to the tissue. Examples include repositioning schedules, specialty mattresses, and boots or casts for the foot.

The ratio of ankle systolic pressure to arm systolic pressure, measured with a Doppler. A value below about 0.9 suggests arterial disease and warns that tight compression may be unsafe.

An open wound, usually near the inner ankle, caused by long-standing high pressure in leg veins. Signs include swelling, brown skin staining, and firm tissue, and compression is the main treatment.

Bandages or stockings that apply graded pressure to the leg to improve venous return and reduce swelling. It is essential for venous ulcers but must be avoided when arterial blood flow is poor.

Swelling caused by poor lymphatic drainage, often after surgery, radiation, or infection. The skin becomes firm and vulnerable to breakdown, and care includes manual drainage, bandaging, exercise, and skin protection.

A wound caused by poor arterial blood supply, commonly on the toes, heel, or outer ankle. It is often painful, has a pale or dry bed, and requires perfusion assessment before debridement or compression.

Nerve damage from high blood glucose that causes numbness, tingling, or burning in the feet. Loss of protective sensation lets small injuries go unnoticed and progress to foot ulcers.

A thin nylon filament pressed against set points on the foot to test protective sensation. Failing to feel the touch at a site indicates loss of protective sensation and a high risk of ulceration.

Progressive breakdown of foot bones and joints caused by neuropathy, producing warmth, redness, and deformity. It is often mistaken for infection, and treatment is immobilization and strict offloading.

A molded cast that spreads weight evenly and limits motion so a plantar neuropathic ulcer can heal. It is considered the standard offloading method for suitable patients with diabetic foot ulcers.

A structured way to prepare a wound bed by addressing Tissue, Infection or inflammation, Moisture balance, and wound Edge. Each element points to a specific action, such as debridement or exudate control.

Removal of dead tissue, debris, and biofilm from a wound using sharp, enzymatic, autolytic, mechanical, or biologic methods. It lowers bioburden and creates a bed that can heal.

A community of bacteria embedded in a self-made film that clings to the wound bed. It resists antibiotics and the body's defenses, so it requires repeated cleansing and physical removal.

A middle state between harmless contamination and true infection in which bacteria multiply and stall healing. Clues include rising exudate, new pain, and a wound that stops improving.

Using antimicrobial products only when needed, with the right agent, dose, and duration, to limit resistance and side effects. In wound care this means treating infection rather than colonization.

Keeping the wound bed moist while the surrounding skin stays dry. Compared with a dry wound, it speeds cell migration, reduces pain, and produces less scarring.

Fluid coming from a wound that contains water, proteins, and cells. Its amount and character guide dressing choice: heavy exudate needs absorbent dressings, while low exudate needs added moisture.

A quick check for poor intake, weight loss, or low body reserves that could impair healing. Findings guide referral for protein and calorie support, since building new tissue requires both.

Using a validated tool such as a numeric scale, faces scale, or behavior checklist before and after care. Controlled pain improves healing, sleep, and the patient's willingness to take part in treatment.