Contents

Abstract

The effective management of nonhealing wounds is based on a complete patient history, a detailed initial assessment of the wound, and an analysis of probable causative factors. This information is used to individualize a management strategy to the underlying pathophysiology preventing healing and to implement appropriate wound interventions. Regular reassessment of progress toward healing and appropriate modification of the intervention are also necessary. Accurate and clinically relevant wound assessment is an important clinical tool, but this process remains a substantial challenge. Wound assessment terminology is nonuniform, many questions surrounding wound assessment remain unanswered, agreement has yet to be reached on the key wound parameters to measure in clinical practice, and the accuracy and reliability of available wound assessment techniques vary. This article, which resulted from a meeting of wound healing experts in June 2003, reviews clinically useful wound measurement approaches, provides an overview of the principles and practice of chronic wound assessment geared to a clinical audience, and introduces a simple mnemonic, MEASURE. MEASURE encapsulates key wound parameters that should be addressed in the assessment and management of chronic wounds: Measure (length, width, depth, and area), Exudate (quantity and quality), Appearance (wound bed, including tissue type and amount), Suffering (pain type and level), Undermining (presence or absence), Reevaluate (monitoring of all parameters regularly), and Edge (condition of edge and surrounding skin). This article also provides some preliminary recommendations targeted to developing best practice guidelines for wound assessment.

Low-frequency (<100 kHz), low-intensity (<100 mW/cm2) ultrasound to treat venous ulcers: A human study and in vitro experiments

“…In contrast, post hoc digital image analysis was conducted using the aforementioned tracing and computational calculation of wound area. This digital analysis method, which is accurate to 0.1 cm 2 (Keast et al, 2004), revealed that three wounds were less than 1 cm 2 in area at the time of enrollment. However, as these wounds were in three separate groups it was deemed that they would not affect statistical analysis and they were included in the 20 subject sample.…”

Efficacy of bacterial cellulose membrane for the treatment of lower limbs chronic varicose ulcers: a randomized and controlled trial

“…We performed the clinical evaluation of the lesion based on the MEASURE 15 interfere directly in the healing process. In addition, the presence of chronic and recurrent lesions may indicate resistance to other treatment protocols.…”

Effective biofilm removal and changes in bacterial biofilm building capacity after wound debridement with low-frequency ultrasound as part of wound bed preparation before skin grafting

“…19 Wound bioburden was evaluated according to the NERDS (N -nonhealing wounds, E -exudate wounds, R -red and bleeding wound surface, D -debris [yellow or black necrotic tissue] on the wound surface, S -smell or unpleasant odor from the wound) and STONES (S -size is bigger, T -temperature is increased, O -Os probe to or exposed bone, N -new or satellite areas of breakdown, E -exudate, erythema, edema, S -smell) principle, which is based on easy-to-use clinical criteria used to diagnose superficial bacterial burden and deep tissue infection. 20 Extensive swab sampling was conducted for semiquantitative and qualitative microbiological analysis.…”