See also the 2016 report, “Surgical Sealants, Glues, Hemostasis, 2016-2022”, Report #S290.
Different classification systems consider tissue wounds from the aspects of severity, morphology, thickness, and etiology. Several methods for classifying wounds have been developed, each determined by the interests of the specialty dealing with the wound. For example, burn specialists have historically classified according to degree of injury, surgeons categorize wounds by severity of tissue loss, while those treating pressure ulcers have their own classification of wounds by stages. Each classification system is useful in generating a prognosis and plan of intervention for each specialty, including the appropriate use of available products. Below are some of the more common classification schemes:
Severity. This classification considers wounds based on the amount of tissue loss or damage, whether the wound also involves nerve, muscle and/or bone, and whether infection is present.
Morphology. This common scheme differentiates wound types categorizes them as partial thickness, deep partial thickness, and full thickness based on the amount of epidermis, dermis, subcutaneous tissue, fascia, muscle and bone. Severity drives the range of therapeutic options necessary and dictates the healing time, the amount of scarring, and the resulting functional impairment.
Etiology. The nature of the cause of the wound formation is a significant determinant of the wound and its severity. Classification by etiology therefore considers the causative event, including surgery, trauma, burns, pressure, venous and diabetic ulcers, radiation, and proliferative scars. Moreover, chronic wounds are understood for their evolution beyond the causative event to result in unique challenges to wound healing.
Classification of Wounds by Etiology
· Surgical wounds
· Traumatic wounds
· Burn wounds
· Ulceration, including pressure, venous, and arterial/diabetic
· Proliferative scars, such as keloids and hypertrophic scars
· Immunosuppressive wounds
· Pharmacological therapeutics
· Radiation wounds
Color. Dressings manufacturers (e.g., Molnlycke) have identified the relevance of wound color, particularly for chronic wounds:
· Black: containing necrotic tissue that needs to be removed
· Yellow: requiring autolytic debridement and moist wound healing
· Red: granulating wounds that require moist wound healing products.
The classification methods, above, are further detailed in MedMarket Diligence report #S247, “Worldwide Wound Management Market, 2009.”