Diagnosis and classification of chronic wounds

The classification of chronic wounds is important for clinical care of patients. The International Classification of Disease codes consider chronic ulcer of the skin with subcategories of decubitus ulcer, lower limb ulcer, ulcer of other specified site, and ulcer of unspecified site.[1] Varicose ulcers, gangrene, and skin infections with ulcers are classified separately. The clinician needs a classification scheme that permits efficient and accurate documentation of a patient's progress toward healing. The therapeutic approach should be based on an understanding of the underlying pathogenesis of the wound, and thus depends on a classification that includes the underlying mechanism for a wound's persistence. This article focuses on methods for recording the size of a wound and reviews the pathogenic mechanisms associated with chronic wounds.