Cochrane Wounds Glossary

Glossary

Acute

Characterised by sharpness or severity; having a sudden onset, sharp rise and short course. Examples of acute wounds are traumatic and surgical wounds. (cf: chronic)

Aetiology

The underlying cause of diseases and disorders.

Albumin

A water-soluble protein found in blood, egg white, milk, etc. The concentration of albumin in the blood is one indicator of nutritional status.

Alginate

Substance derived from algic acid, found in seaweed, used in making dressings for wounds.

Ambulant

Able to walk.

Ankle Brachial Pressure Index (ABPI) 

The ratio of blood pressure at the ankle to that in the arm. This ratio provides a measure of the degree of arterial disease in the legs, where a value of 1.0 indicates that there is no reduction in blood supply to the legs, compared with the anus. A ratio of 0.9, 0.8, or lower indicates reduced blood supply to the lower limbs.

Anticoagulant

A drug that decreases the ability of the blood to clot. Blood clots (thromboses) in the veins can damage blood flow. If blood clots move through the circulation they can block the blood flow through a major blood vessel. 

Anti-inflammatory

A drug or treatment designed to reduce inflammation (i.e. redness, heat, swelling, etc).

Aphthous

Ulceration on a mucous membrane. Aphthous ulcers are the most common type of mouth ulcers.

Arterial

Of the artery (ies).

Arterial ulcer

An area of skin loss (see ulcer, ischaemic ulcer), caused by insufficient arterial blood supply to the lower limb.

Attrition

Gradual wearing down or shrinking. In the context of randomised trials, attrition relates to the loss of participants from a trial.

Bacteria

These simple micro-organisms are usually composed of a single cell. There are thousands of types of bacteria, both beneficial and harmful.

Bacterial interference

The effect different micro-organisms can have on each other, like partial or complete inhibition or sometimes facilitation.

Bacteremiae

Presence of a pathogenic micro-organism in the bloodstream which can cause metastatic infections in the whole body (e.g. endocarditis). 

Bed sore

See pressure ulcer.

Calcaneal 

Refers to the heel bone.

Calf-pump mechanism

The action of the calf muscles upon walking or ankle flexion, which results in venous blood being pumped back towards the heart.

Callus/callous

A hard, thick area of skin or tissue.

Capillary permeability

Capillaries are the final branch of the circulation system. The small vessels are formed by a single layer of epithelial cells. The junctions of these cells are permeable, allowing soluble proteins to escape from the blood system to the tissues around the vessels. The degree of permeability (leakiness) changes due to changes in physiology (e.g. in blood pressure).

Cardiac

Usually relating to, situated near, or acting on the heart. Less commonly, relating to the cardia of the stomach.

Catheter

Hollow tube inserted into blood vessels, passageways or body cavities, usually to permit injection or withdrawal of fluids, or to keep a passage open, e.g. intravenous catheter, urinary catheter.

Chronic

Marked by long duration, by frequent recurrence over a long time, and often by slowly progressing deterioration; having a slow progressive course of indefinite duration. Examples of chronic wounds are pressure ulcers, leg ulcers and diabetic foot ulcers. (cf: acute).

Claudication

A cramping pain, especially in the leg, caused by arterial obstruction or narrowing.

Closure method

Method of closing a surgical incision, e.g. using stitches (sutures), glue or staples.

Collagen 

A protein found throughout the body, including the skin.

Colony forming units (CFUs) 

A unit of measurement of groups of bacteria; one swab may contain millions of CFUs.

Compression therapy

The application of external pressure to a limb, to help venous blood or lymph circulation. Compression can be applied using bandages, elastic stockings or inflatable sleeves.

Cosmesis

Considerations relating to cosmetic outcomes.

Cosmetic outcome

An outcome serving or designed to have an acceptable appearance or to beautify the body.

Cyanoacrylate

An adhesive, derivative of cyanide, used in wound therapy, e.g. to join the edges of skin incisions.

Debridement

The removal of foreign material and dead or damaged tissue from a wound.

Dehisce

Separation of layers of a surgical wound, which may be superficial, partial or complete. Complete dehiscence may lead to evisceration (q.v.)

Dermis

The deep inner layer of the skin, beneath the epidermis, containing connective tissue, blood vessels and fat.

Diabetes

A metabolic disorder affecting the metabolism of energy reserves for the body. The most common type is diabetes mellitus. Less common is diabetes insipidus. See diabetes mellitus.

Diabetes mellitus

A metabolic disorder resulting from a defect in insulin secretion, insulin action, or both. The two most common forms are Type 1 and Type 2 diabetes mellitus. Other, less common, forms also exist. For more detailed information, see Cochrane Metabolic and Endocrine Disorders Group Glossary.

Diabetic ulcer

An area of skin loss (see ulcer) resulting from poor blood supply and/or reduced nerve function in the lower limb caused by diabetes mellitus.

Distal

Situated away from the centre of the body, or point of attachment if proximal.

Diurnal variation

Variation during the day, or daily.

Donor site

When significant areas of skin are damaged, for example in burns, then a skin graft is one treatment. The skin graft is taken from an area of healthy skin, e.g. the thigh or stomach and the acute wound caused is called the donor site.

Drainage

Removal of exudate (q.v.) from a wound.

Drapes

Pieces of fabric or plasticised film, used to isolate a surgical site.

Dystrophy

Impaired nourishment of an organ or part of the body; disordered growth. 

Edema

See Oedema.

Electrotherapy

The application of electrical energy to help a wound or impaired function. A number of types of electrotherapy are used in wound management.

Endocrine

A gland that manufactures one or more hormones (q.v.) and in most cases secretes them directly into the bloodstream.

Endothelium

The membrane lining various vessels and cavities of the body.

Enzymes

Complex proteins produced by living cells involved in specific biochemical reactions. e.g. proteases.

Epidermis 

The outer layer of the skin, made up of flattened, dead, epithelial cells.

Epithelial loss

Loss of fluids or other matter through the epithelium (q.v.).

Epithelialisation

Coverage of a wound by epithelial cells migrating across from the edges of healthy tissue. A wound is regarded as healed when it is completely covered with epithelial cells.

Epithelium

The cellular layer that forms the epidermis of the skin and lines the hollow organs and all passages of the respiratory, alimentary and genitourinary systems.

Erythema

Redness of the skin, caused by increased blood flow; may be localised or generalised.

Evisceration

Extrusion of the viscera (organs) outside the body following the dehiscence of a surgical wound

Experimental wound

A wound created intentionally for the purpose of testing different methods of treatment, or studying wound healing/scarring.

Extracellular matrix

A mass of additional cells and ground substance formed on, over or under the matrix i.e. the collection of tissue, bone, cartilage, etc, at the base of a wound.

Exudate

Fluid, which leaks out of a wound.

Fibrin cuff

A layer of fibrin formed on a capillary, due to the leakage of soluble fibrinogen into the extra capillary space. The fibrin cuff may be involved in reducing nutrient flow from the capillaries.

Fibrinogen

A soluble blood plasma protein, which produces fibrin when acted upon by the enzyme thrombin.

Fistula 

Abnormal opening between two hollow organs, or between a hollow opening and the exterior.

Flora: non-pathogenic bacteria living in a body cavity (e.g. intestine)

Fungus

A simple plant that is parasitic on other plants and animals. Fungi are found on the skin and when they multiply they can cause infections such as ringworm or athlete's foot.

Gastroenterology

The branch of medicine, which deals with disorders of the stomach and intestinal tract.

Gastrointestinal

Relating to the stomach and the intestines.

Gland

An organ secreting substances for use in the body.

Glucose

A simple sugar. One of the most important basic carbohydrate (sugar) units in living organisms.

Granulation tissue

Delicate tissue composed mainly of tiny blood vessels and fibres, formed at the site of a wound or infection as part of the healing process.

Gynaecology

Branch of medicine concerned with diseases and conditions specifically concerned with female reproductive organs.

Haemoglobin

The protein in red blood cells which carries oxygen from the lungs.

Haemorheological agent

A drug, which acts on red blood cells.

Hormone

One of a number of naturally occurring substances transmitting 'messages for action' to different parts of the body. Hormones are produced by endocrine glands/tissues, are secreted into the bloodstream and carried to distant tissues or organs where they act to modify their structure or function.

Hydrocolloid

Dressing which reacts with wound exudate to maintain the moisture at the surface of a wound.

Hydrogel

Water based jelly-like substance, which can be used for the same purpose as hydrocolloid dressings.

Hyperbaric oxygen

Oxygen at a pressure higher than normal.

Hypertension

Abnormally high blood pressure.

Hypertrophic scar

An area of enlarged scar tissue (see keloid).

Incision

A cut or wound, usually a surgical opening.

Induration

The pathological hardening of a tissue or organ. May occur when a tissue is infected or when it is invaded by cancer.

Infusion site

Site of the entry into the body of a cannula (tube) to allow the passage of drugs or fluids direct into a vein.

Insulin

Hormone secreted by the pancreas in response to blood glucose. It is involved in regulating blood glucose levels and promotes fuel storage.

Ischaemia 

Deficient blood supply to any part of the body.

Ischaemic ulcer

Area of skin loss (see ulcer, arterial ulcer) resulting from deficient blood supply.

Keloid

A hard smooth pinkish raised growth of scar tissue at the site of an injury tending to occur more frequently in dark-skinned people (see hypertrophic scar).

Laceration

A wound to the skin or surface of an organ, which results in a cut with irregular edges.

Laser therapy

Light Amplification through Stimulated Emission of Radiation. A light beam that heats and coagulates tissues, therefore stopping extensive bleeding. Laser energy directed at wounds is used to aid healing.

Lesion

Disease changes in organs or tissues; a wound.

Lipodermatosclerosis

Area of pigmentation and hardened skin caused by leakage of red blood cells into the skin. Seen in people with chronic venous insufficiency.

Lymphoedema

Persistent swelling of the tissues as a result of inadequate drainage of the lymph channels (see oedema).

Macrovascular disease

Disease of the large veins.

Malnutrition

Lack of adequate nutrition, resulting from poor or unbalanced diet, insufficient food or defective assimilation of food.

Maxillofacial

Referring to the upper jaw and face.

Medial gaiter area

Inner area of the lower leg, between the ankle and calf muscle.

Microbe

A living organism so tiny it can only be seen through a microscope; e.g. a bacteria, a virus. 

Microbial contamination

Dirtying of hands, instruments, etc, by microbes.

Microcirculatory

Referring to the microcirculation of small arteries (arterioles) veins (venules) and capillaries.

Microorganisms (or micro-organisms)

See microbe.

Mobility

The ability to move about (cf ambulant).

Monomer

A compound whose chemicals can join together to form a polymer; (polymer being a compound such as starch or Perspex, that has large molecules made up of many relatively simple units).

Morbidity

A diseased state or symptom; the incidence of disease; the rate of sickness, the human suffering from a health problem.

Mortality 

Death; the incidence of death; death rate.

Mucocutaneous junctions

Junctions of skin and mucous membranes, e.g. the lips.

Mucous membrane

Membrane which lines many of the hollow organs of the body. Lubricated by mucous, secreted either by cells on the surface of the membrane or glands beneath it.

Necrotic tissue

Dead or dying tissue, which may be due to the interruption of blood supply.

Negative pressure therapy

Therapy, which involves lowering the air pressure to below normal atmospheric pressure, to suck material from a wound. Also known as VAC(R), or topical negative pressure therapy.

Nosocomial

Acquired in the hospital

Non-calcaneal callus

A callus (a hardened or thickened area of skin) that does not project from the surface.

Obstetrics

The branch of medicine concerned with pregnancy and childbirth.

Occlusion

The closing or obstruction of a duct, hollow organ or blood vessel.

Oedema, edema

Swelling. An abnormal accumulation of fluid beneath the skin, or in one or more of the cavities of the body (see lymphoedema).

Oral

Relating to the mouth.

Orthopaedic

Referring to the branch of surgery concerned with the bones and joints.

Osteomyelitis

Inflammation in the marrow of a bone, can occur as a complication of infected diabetic foot ulcers.

Oxygen therapy

Application of oxygen to a wound site to promote healing.

Pathogen

Any agent such as bacteria or a virus that is capable of causing disease.

Pathogenic

Causing a disease

Paediatric

Referring to the branch of medical science concerned with children and their diseases.

Perforation

A hole or puncture.

Perfusion

The transfer of fluid through tissue.

Peripheral

Outlying. For example: peripheral neuropathy - affects the nerves in the outlying parts of the body; peripheral vascular disease - disease of the small blood vessels close to the surface of the skin.

Phagocytic

Cells, including white blood cells and macrophages, which envelop and digest bacteria, cells, cell debris and other small particles.

Pharmacology

The part of medical science dealing with knowledge of the action of drugs.

Pigmentation

Colouring.

Pilonidal sinus

A wound, thought to derive from hair follicles in the cleft between the buttocks. May become infected and cause considerable pain.

Plantar

Relating to or occurring on the sole of the foot.

Plastic surgery

The branch of surgery concerned with repair or reconstruction of missing, injured or malformed parts or tissues - particularly the skin and its underlying structures.

Platelets

Small spherical bodies in the blood, platelets play an important part in the process of blood coagulation.

Podiatry

The study and care of the foot.

Post-thrombotic ulcers

Ulcers caused by poor venous return due to blockage of the veins, following a blood clot (thrombosis).

Post-operative 

Relating to, occurring in, or being the period following a surgical operation.

Pressure dressing

Dressing which applies pressure to a wound, usually to arrest bleeding.

Pressure redistribution

Equalisation of pressure across an area of skin or tissue to prevent pressure sores.

Pressure sore 

See pressure ulcer

Pressure ulcer

Area of inflamed skin/broken skin, caused by excessive or prolonged pressure shear or friction. This prevents adequate blood flow to the skin and finally the death of skin and underlying tissues

Psoriasis

A common skin condition, characterised by persistent localised scaly pink patches, often on the elbows, knees and scalp.

Re-approximating

Bringing together the edges or surfaces of a cut or laceration.

Regimen

A prescribed health system: - medication, diet or exercise.

Rheumatoid

Chronic inflammation of linings of joints, tendons, sheaths or bursae.

Rheumatoid ulcer

Area of skin loss (see ulcer) resulting from rheumatic disease.

Risk assessment scales

Criteria used to determine those aspects of a person's condition, lifestyle or environment that increase the probability of occurrence of a disease or condition. For example, pressure ulcer risk assessment scales are used to help predict which people are at high risk of developing a sore and therefore who requires additional treatment to prevent an ulcer.

Scarring

Dense, fibrous tissue on the surface of a healed wound, ulcer or other breach of tissue. 

Sebaceous glands

Small glands in the skin that secrete an oily lubricant into hair follicles, or over the surface of most of the body.

Shear

Force acting along the line of the edge of the skin. One of three factors known to contribute to the development of pressure ulcers.

Sickle cell ulcer

Area of skin loss (see ulcer) resulting from sickle cell disease.

Sinus

A tract leading from a deep infected area to a surface; a hollow space in a bone or bony structure.

Skin abscess

A localised collection of pus, surrounded by damaged and inflamed tissue.

Skin grafting

Treatment for large areas of damaged skin (e.g. in burns). Healthy skin is taken from an area such as the thigh or stomach and applied to the wound site to promote healing and reduce scarring.

Stellate

Resembling a star in shape.

Sternal

Concerned with the sternum, or breastbone.

Sub-atmospheric pressure therapy

See negative pressure therapy.

Suture

The series of stitches by which a wound is closed; the union between two neighbouring bones of the skull.

Systemic drug therapy

Therapy involving a drug, which affects the whole of the body and not just a part of it.

Therapy

The treatment of disorders or disease.

Therapeutic touch

Treatment by a therapist in which they direct healing energy to a body/ part of body either by direct touch or by holding hands near an affected part and transmitting healing energy.

Tissue

The simple elements from which the various parts and organs of the body are built.

Topical agent

Drug or other treatment applied locally to the area being treated.

Toxicity

The degree or strength of a poison.

Transient

Of short duration.

Trauma

Term used to describe a wound caused by an injury.

Traumatic wound 

Wound resulting from injury, e.g. a burn, gunshot wound, laceration or bite.

Tropical ulcer

Type of ulcer (q.v.) common in tropical latitudes.

Tubular elastic bandage

Elastic fabric, tubular in design, which encloses an area of limb.

Ulcer

An open sore, marked by complete loss of the top layer of the skin (epidermis); which does not tend to heal quickly. (See arterial ulcer, diabetic ulcer etc).

Ultrasound

Sound of a frequency above 15, 000 cycles per second (15 kHz). Used in health care as a diagnostic tool and in the treatment of acute soft tissue injuries.

Unna boot

Layered dressing developed to treat venous leg ulcers - the layer next to the skin consists of a zinc oxide impregnated cotton bandage, the next layer is a compression bandage.

Vacuum sealing technique

Any means of sealing the negative pressure device so that a vacuum is created and matter sucked from the wound.

Vascular

Relating to the vessels in the body, which circulate fluid, such as blood.

Venous

Of the vein(s).

Venous ulcer

Ulcer (q.v.) resulting from poor blood flow in the veins and/or high blood pressure in the veins of the lower leg.

Venous reflux

Blood within the veins flowing back in the opposite direction to that which is normal. Occurs in veins in which the valves have become inactive or incompetent.

Venous stasis

'Pooling' of blood in a vein, occurs when the blood vessel's valves are inactive and its walls inelastic.

Viscosity

(Of a fluid). Resistance to flow.