NEW WOUND TEMPLATE (COMMENT SECTION)

Wound #:
Wound bed: (slough %, eschar %, granulation %)
Wounds edges: (defined, undefined, attached or unattached, rolled under, macerated, fibrotic
or callused)
Undermining/Tunneling: (location on clockface and measurement)
Surrounding Skin: (color, firmness, pallor, edema, induration, any lesions, scarring, rashes,
moisture)
S/S of Infection:
Response to care/treatment: (evidence of healing, response, compliance)

WOUND TEMPLATE FOR WOUNDS 6 & UP

Wound #:
Location:
Onset Date:
Etiology:
Pressure Injury Stage: (1,2,3,4, dti, unstageable)
Size: Length x Width x Depth
Drainage: amount (none, scant, small, moderate or large/copious) and type of drainage (serous,
sanguineous, serosanguineous and purulent)
Odor: (none, foul, cleared or didn’t clear with cleansing?)
Wound bed: (slough %, eschar %, granulation %)
Wounds edges: defined, undefined, attached or unattached, rolled under, macerated, fibrotic,
callused)
Undermining/Tunneling: (location on clockface and measurement)
Surrounding Skin: (color, firmness, pallor, edema, induration, any lesions, scarring, rashes,
moisture)
S/S of Infection:
Response to care/treatment: (evidence of healing, response, compliance)