sometimes painful Layers involved • Blanches under pressure Epidermis only • Minimal tissue damage • Usually no blisters Healing ability Ability to heal themselves within 7 days
• Wound bed, normally Layers involved pink/red Superficial dermis –papillary • Moist with moderate exudate Healing ability • Brisk capillary refill Ability to heal themselves by • Very painful epithelialisation within 14 days • Sensitive to pain air & temperature
Partial Thickness • Red/ Pale white creamy
Deep Dermal wound bed • If blisters present, easy to Layers involved separate, loose epidermis Deep dermis – reticular • Sluggish capillary refill • Slight pain but mostly Healing ability insensate. Sensitive to Prolonged healing resulting in deep pressure but not scarring or requires surgical pinprick excision
Full Thickness • White, cream or cherry
red wound bed Layers involved • Black/brown leathery Through entire dermis to eschar subcutaneous layer • Pain can be non existent in specific areas; however Healing ability consideration needs to be Prolonged healing resulting in given to anxiety and any scarring or requires surgical more painful superficial excision areas. • Thrombosed vessels may be visible
Refill Epidermal Red No Present Present Yes Superficial Pale Pink Small Present Painful Yes Dermal Mid-Dermal Dark Pink Present Sluggish +/- Usual Deep Dermal Blotchy Red +/- Absent Absent No Full Thickness White No Absent Absent No