The Teler system is a method for taking and presenting clinical notes so that the information is available to clinicians, auditors and researchers. Grocott used the concept to develop a system for describing fungating wounds and for monitoring them over time. The author is from King's College in London.
NOTE: The system applies to have been used for patients with fungating, neoplastic ulcerations. However, it could be used for any chronic, exudative wound.
Measures:
(1) dressing fit and adjustments (including re-taping, re-padding, or re-positioning)
(2) number of dressing changes and re-paddings
(3) amount of exudative leakage
|
Parameter |
Finding |
Code |
|
dressing fit relative to shape and size of wound |
dressing conforms with all edges attached; no adjustments required |
5 |
|
|
dressing conforms with all edges attached; adjustment needed between dressing changes |
4 |
|
|
dressing does not conform, with 2 or 3 edges attached; no adjustments needed |
3 |
|
|
dressing does not conform, with 2 or 3 edges attached; adjustments needed between dressing changes |
2 |
|
|
dressing does not conform with 1 edge only attached; no adjustments needed |
1 |
|
|
dressing does not conform to size or shape of wound with only 1 edge attached; adjustments needed between dressing changes |
0 |
|
dressing changes and re-paddings needed beyond scheduled daily change |
none |
5 |
|
|
dressing re-padded once more |
4 |
|
|
dressing re-padded more than once |
3 |
|
|
complete dressing change once only |
2 |
|
|
complete dressing change more than once |
1 |
|
|
dressing changed within 1 hour of application |
0 |
|
exudate leakage |
minimal, dressing only soiled |
5 |
|
|
dressing only is sodden |
4 |
|
|
dressing is wet bedding and/or clothes are soiled |
3 |
|
|
dressing wet bedding and/or clothes are wet |
2 |
|
|
dressing soaked bedding and/or clothes soaked |
1 |
|
|
dressing stained in patches bedding and clothes soaked |
0 |
Interpretation:
• The higher the code, the better the wound status.
• With effective management the codes should trend higher over time.
• With deterioration or progression of the wound, the codes should trend lower.
Specialty: Dermatology, Surgery, general
