Triangle of Wound Assessment Made Easy: Revisited

Hashim Mohamed* and Badriya Al Lenjawi

Triangle of Wound Assessment Made Easy: Revisited.

We have provided evidence based critical review of the Triangle of wound assessment made easy
Wound assessment is a vital step in managing patients with acute and chronic wounds in daily
clinical practice.

The natural progression of most wounds is to heal naturally
in a coherent and timely manner, although a minority of wounds will fail to heal.

The aim of treating recalcitrant wounds that fail to heal is to control symptoms and delay
or prevent complications. One vital step in managing wounds is proper and comprehensive
evidence based wound assessment.

We have revised the concept of raised white blood cell count as a sign of infection and
argued that in up to one-half of patients, even with severe diabetic foot infection
raised temperature, WBC count, or sedimentation rate are absent.

A second point of concern is the omission of probing to bone sign in the diagnostic criteria
of local signs of infection.

Recent clinical studies have demonstrated that in the presence of a clinically infected ulcer,
a positive Probe-to-Bone Test test is highly suggestive of osteomyelitis, but a negative test
does not rule out the diagnosis;

conversely, in the situation of an apparently uninfected foot wound,
a positive PTB test is not specific for osteomyelitis, but this diagnosis is unlikely if the PTB test is negative.

Lastly, the authors have suggested reducing wound bio burden/manage infection
through the use of topical antimicrobial therapy-including antiseptic agents.

Dermatol Open J. 2016; 1(3): 51-55. doi: 10.17140/DRMTOJ-1-114