Wound Care/Pressure Injury Management Questions and Answers 2026

Wound Care/Pressure Injury
Management Questions and Answers
2026
principlesBforBpracticeB-
BAnswer•BTheBskinBisBtheBlargestBexternalBorgan.BItBhasBtwoBlayers:BtheBepidermisBandBtheB
dermisB(Fig.B39.1).BTheBepidermisBhasBfiveBlayers.

•BStratumBcorneum,BtheBoutermostBlayer,BconsistsBofBflattenedBdeadBkeratinizedBcells.BStratu
mBcorneumBpreventsBdehydrationBofBunderlyingBcellsBandBisBaBphysicalBbarrierBtoBtheBentryB
ofBcertainBchemicals.BThisBlayerBisBlikeBtheBshinglesBonBaBroofBthatBprovidesBprotectionBfrom
BoutsideBelements.

•BTheBnextBlayersBofBtheBepidermisBareBtheBstratumBlucidum,BstratumBgranulosum,BandBstrat
umBspinosum.

•BStratumBgerminativum,BtheBinnermostBlayer,BisBsometimesBcalledBtheBbasalBlayer.BImportant
BfeaturesBofBtheBstratumBgerminativumBareBtheBepidermalBprotrusions,BorB"peaksBandBvalleys
"BthatBpointBdownwardBintoBtheBdermis.BTheseBprovideBresiliencyBandBintegrityBtoBtheBskinB
structure.BMelanocytes,BtheBcellsBthatBgiveBtheBskinBitsBcolor,BareBalsoBinBthisBlayer.

•BTheBareaBthatBseparatesBtheBepidermisBfromBtheBdermisBisBcalledBtheBdermoepidermalBjun
ctionBorBtheBbasementBmembraneBzone.

•BBeneathBtheBepidermisBisBtheBdermis.BCollagenB(aBtoughBfibrousBproteinBlayer),BbloodBvess
els,BandBnervesBcomposeBtheBdermalBlayer.BCollagenBcomposesBaboutB70%BofBtheBdermisBan
dBisBextremelyBimportantBinBwoundBhealing.BTheBdermisBrestoresBtheBphysicalBpropertiesBofB
theBskinBandBitsBstructuralBintegrity.BRestorationBofBbothBtheBepidermalBandBdermalBlayersBis
BnecessaryBtoBpromoteBhealing.BRiskBforBlocalBorBsystemicBinfection,BimpairedBcirculation,Ban
dBbreakdownBofBtissueBdirectlyBimpairsBtheBwound-
healingBabilityBofBtheBskinBlayersB(DoughtyBandBSparks-Defriese,B2016).

•BWoundsBshouldBbeBassessedBonBaBscheduledBbasisBtoBdetermineBifBtheBwoundBisBmovingB
towardBhealing.BIfBtheBassessmentBrevealsBthatBtheBwoundBisBnotBprogressingBasBexpected,Bt
heBplanBofBcareBcanBbeBchangedBtoBfacilitateBwoundBhealingB(seeBProceduralBGuidelineB39



Black/brownBwounds/escharB-BAnswer-BlackBorBbrownBtissueBisBeschar,BwhichBrepresentsBfull-
thicknessBtissueBdestruction.BBlackBisBusedBtoBdescribeBnecroticBtissueBorBdesiccatedBtissueBs
uchBasBtendon.BItBisBalsoBrelatedBtoBgangrenousBlesionsBsecondaryBtoBperipheralBvascularBdis
ease.

-
IfBtheBgoalBforBaBwoundBcoveredBwithBescharBisBdebridement,BsharpBdebridementBisBusedBt
oBquicklyBremoveBtheBtissue,BchemicalBdebridementBisBusedBtoBsoftenBtheBtissueBforBremoval
,BorBaBmoistBdressingBisBalsoBconsideredBtoBloosenBtheBtissue.BTheBmethodBofBdebridementB
dependsBonBtheBoverallBgoalBforBtheBpatient.

, YellowBwounds/sloughB-BAnswer-
YellowBtissueBrepresentsBnonviableBtissueBandBinBsomeBcasesBtheBpresenceBofBanBinfection.B
SloughBtissueBcanBbeByellow;BcreamBcolored;BorBgrayBslough,BwhichBisBusuallyBaccompaniedB
byBpurulentBdrainage.

-ForBpatientsBwithBaBlowBinfectionBrisk,BtheBuseBofBmoisture-
retentiveBdressingsBenhancesBdebridementBofBtheByellow/sloughBtissue.BMoisture-
retentiveBdressingsBmayBincludeBmoistBdressings,Bhydrocolloids,Bhydrogels,BorBalginates.BIfBthe
BwoundBisBinfected,BtopicalBantimicrobialsBareBused.



RedBwounds/granulationB-BAnswer-
RedBtissueBrepresentsBtheBpresenceBofBgranulationBtissue.BTheBredBcolorBisBtheBresultBofBan
BincreasingBamountBofBnewBbloodBvesselsBinBtheBwoundBandBisBconsideredBhealthy.

-
TheBgoalBinBmanagementBofBaBredBgranulatedBwoundBisBtoBselectBaBdressingBthatBmaintains
BaBcleanBandBmoistBwoundBenvironmentBandBminimizesBdamageBtoBhealingBtissue.



FactorsBthatBInfluenceBWoundBHealingB-
BAnswer•BHypovolemia,Bhypotension,Bvasoconstriction,Bedema,BandBhypoxiaBnegativelyBaffectB
woundBhealingBbecauseBadequateBperfusionBandBoxygenationBareBnecessaryBforBnewBvesselBd
evelopment,BcollagenBsynthesis,BandBdevelopmentBofBtensileBstrength.

•BAnBadequateBnutritionalBstatusBisBcriticalBforBcollagenBsynthesis,BtensileBstrength,BandBimm
uneBfunction.

•BWoundBinfectionBprolongsBtheBinflammatoryBresponse,BandBtheBmicroorganismsBuseBnutrien
tsBandBoxygenBneededBforBwoundBrepair.

•BABpatientBwithBdiabetesBmellitusBmayBhaveBimpairedBwoundBhealingBbecauseBofBabnormal
BandBprolongedBinflammation,BreducedBcollagenBsynthesis,BandBimpairedBepithelialBmigration.
BHyperglycemiaBisBassociatedBwithBcompromisedBneutrophilBfunctionBandBimpairedBmigration.

•BCorticosteroidBtherapyBorBtheBuseBofBotherBimmunosuppressiveBagentsBsuchBasBchemother
apyBincreasesBtheBpatient'sBsusceptibilityBtoBinfection.

•BAdvancedBageBcanBcontributeBtoBaBdiminishedBproliferationBofBcellsBcriticalBtoBrepair.



PerformingBaBWoundBAssessmentB-BAnswer-
WoundBassessmentBprovidesBtheBbaselineBforBplanningBandBevaluatingBtheBwoundBcareBplan.
BNormalBwoundBhealingBoccursBinBanBorganizedBfashion,BandBevaluatingBtheBwoundBstatusBp
rovidesBanBongoingBassessmentBofBwoundBhealingBandBhelpsBtoBdetermineBwoundBtreatment
s.BTheBfrequencyBofBwoundBassessmentBdependsBonBtheBpatient'sBoverallBcondition,BpolicyBo
fBtheBhealthBcareBsetting,BtypeBofBdressingsBused,BandBoverallBpatientBgoalsB(Nix,B2016).BAcu
teBcareBsettingsBgenerallyBrequireBwoundBassessmentBdailyBorBwithBeachBdressingBchange.BLo
ng-
termBcareBfacilitiesBmayBrequireBanBinitialBadmissionBwoundBassessmentBandBweeklyBassessm
entBforBchronicBwounds.BCheckBagencyBpolicyBforBfrequencyBofBwoundBassessmentBandBspeci