The status of a surgical wound may be described using OASIS (Outcome and Assessment Information Set) terminology. The terms were formulated by HCFA to guide reimbursement of care. The following are based on the WOCN (Wound, Ostomy, Continence Nurse Society) Guidance document.
Wound evaluated: most problematic, else most readily observable
Types of closures:
(1) primary intention (approximated incisions)
(2) secondary intention (healing of dehisced wound by granulation, contraction and re-epithelialization)
Terms:
(1) fully granulating/healing
(2) early/partial granulation
(3) non-healing
|
Feature for Primary Intention |
Fully granu-lating/healing |
Early/partial granulation |
Non-healing (1 or more of the following) |
|
incision |
well-approximated |
well-approximated |
separation |
|
epithelialization |
complete |
incomplete |
necrosis |
|
signs or symptoms of infection |
none |
none |
present |
|
healing ridge |
well-defined |
palpable but poorly defined |
none palpable |
|
Feature for Secondary Intention |
Fully granu-lating/healing |
Early/partial granulation |
Non-healing (1 or more of the following) |
|
wound bed |
filled with granulation tissue to level of surrounding skin or new epithelium |
>= 25% of wound bed with granulation tissue |
clean but nongranulating |
|
avascular tissue |
none, with no dead space |
< 25% of wound bed |
>= 25% of wound bed |
|
signs or symptoms of infection |
none |
none |
present |
|
wound edges |
open |
open |
closed or hyperkeratotic |
|
other |
NA |
NA |
persistent failure to improve despite comprehensive appropriate wound management |
Specialty: Surgery, orthopedic, Emergency Medicine, Critical Care, Surgery, general
