(BQ) Part 2 book “Text and atlas of wound diagnosis and treatment” has contents: Flaps and skin grats, wound debridement, burn wound management, factors that impede wound healing, wound dressings, electrical stimulation, negative pressure wound therapy, pulsed lavage with suction, and other contents. | C H A P T E R E I G H T Atypical Wounds Jayesh B. Shah, MD, CWSP, FACCWS, FAPWCA, FUHM, FAHM and Rose L. Hamm, PT, DPT, CWS, FACCWS CHAPTER OBJECTIVES At the end of this chapter, the learner will be able to: 1. Recognize signs of an atypical wound. 2. Categorize an atypical wound into a basic pathology. 3. Determine the appropriate medical specialist for a given wound. 4. Develop an evidence-based care plan for an atypical wound. 5. Educate the patient and family about the wound diagnosis. INTRODUCTION Most wounds are diagnosed as arterial, venous, pressure, neuropathic, surgical, or burn and are treated according to the principles that have been discussed in the previous chapters. If a wound has a different appearance or does not respond to standard care, the clinician is challenged to determine either the factors that are inhibiting healing or to consider a different diagnosis. This chapter reviews the basic morphology of skin disease, red flags of atypical wounds, and characteristics of different diagnostic categories. The pathophysiology, clinical presentation with photographs, differential diagnosis, medical management, and wound management of each wound category are provided to assist the clinician in making sound clinical decisions. CHARACTERISTICS OF ATYPICAL WOUNDS The first signal that a wound is atypical is that little signal in the clinician’s instinct that says, “This is just not quite what it looks to be.” And usually it behooves the clinician to follow those instincts, to at least rule out an atypical diagnosis, and at most to make a differential diagnosis that completely changes the care plan and results in wound healing. TABLE 8 1 provides a list of characteristics that suggest a wound does not fall into the typical MORPHOLOGY OF SKIN DISEASE Many diseases will cause changes in the skin that are predictable and/or suggestive of a certain diagnosis. TABLE 8 2 provides a list of terms and definitions of integumentary characteristics .
