eMedicine Specialties > General Surgery > Wounds

Wound Care: Workup

Author: Richard M Stillman, MD, FACS, Honorary Medical Staff, Northwest Medical Center; Former Chief of Staff and Medical Director, Wound Healing Center, Department of Surgery, Northwest Medical Center
Contributor Information and Disclosures

Updated: Sep 29, 2009

Workup

Laboratory Studies

  • Tests that sometimes are useful in identifying underlying factors that can slow wound healing include the following:
    • CBC to assess for leukocytosis, anemia, and thrombocytopenia
    • Analysis of the patient's basic metabolic profile to look for renal insufficiency and electrolyte abnormalities
    • Determination of serum protein, albumin, prealbumin, and transferrin levels to assess the patient's nutritional status
    • Coagulation studies to evaluate for coagulation abnormalities, especially if deep wound excision is required
    • Tissue cultures of wound to determine appropriate antibiotic therapy
  • Laboratory studies that may play a role in evaluating specific wound etiologies include vascular laboratory studies (eg, plethysmography, pulse-volume recordings [PVRs]) to check the hemodynamic significance of arterial occlusive disease.

Imaging Studies

  • Imaging studies that may play a role in evaluating certain wound etiologies.
    • Plain radiography, CT, and MRI may help in looking for underlying osseous abnormalities, proximity of the wound to hardware, or foreign bodies.
    • Vascular ultrasonography may be indicated to evaluate for aneurysmal disease or deep venous occlusion.
    • Bone scanning may be needed to look for possible osteomyelitis. Technetium-99m–labeled WBC scanning (Ceretec) has high specificity and sensitivity for osteomyelitis. However, it requires 24 hours for completion and it lacks anatomic detail.

Diagnostic Procedures

  • Perform a biopsy of every suspicious wound, but remember that biopsy results are diagnostic only if an adequate representative specimen is obtained.

More on Wound Care

Overview: Wound Care
Workup: Wound Care
Treatment: Wound Care
Follow-up: Wound Care
Multimedia: Wound Care
References
Further Reading
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Keywords

wound healing, pressure ulcer, diabetic foot, diabetic ulcer, foot ulcer, debridement, decubitus, pressure ulcers, bed sore, bed sores, bedsores, debride, pressure sores, decubitus ulcer, venous ulcer, diabetic feet, decubitus ulcers, debriding, debrided, decubitus ulcers, neuropathic ulcers, venous ulcers, venous stasis ulcers, arterial ulcers, foot ulcers

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Contributor Information and Disclosures

Author

Richard M Stillman, MD, FACS, Honorary Medical Staff, Northwest Medical Center; Former Chief of Staff and Medical Director, Wound Healing Center, Department of Surgery, Northwest Medical Center
Richard M Stillman, MD, FACS is a member of the following medical societies: American College of Angiology, American College of Surgeons, Association for Academic Surgery, and Society of University Surgeons
Disclosure: Nothing to disclose.

Medical Editor

Brian James Daley, MD, MBA, FACS, Associate Program Director, Professor, Department of Surgery, Division of Trauma and Critical Care, University of Tennessee School of Medicine
Brian James Daley, MD, MBA, FACS is a member of the following medical societies: American Association for the Surgery of Trauma, American College of Chest Physicians, American College of Surgeons, American Medical Association, Association for Academic Surgery, Association for Surgical Education, Eastern Association for the Surgery of Trauma, Shock Society, Society of Critical Care Medicine, Southeastern Surgical Congress, and Tennessee Medical Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Amy L Friedman, MD, Professor of Surgery, Director of Transplantation, State University of New York Upstate Medical University College of Medicine, Syracuse
Amy L Friedman, MD is a member of the following medical societies: American College of Surgeons, American Medical Association, American Medical Women's Association, American Society for Artificial Internal Organs, American Society of Transplant Surgeons, American Society of Transplantation, Association for Academic Surgery, Association of Women Surgeons, International College of Surgeons, International Liver Transplantation Society, New York Academy of Sciences, Pennsylvania Medical Society, Philadelphia County Medical Society, Society of Critical Care Medicine, and Transplantation Society
Disclosure: Nothing to disclose.

Chief Editor

John Geibel, MD, DSc, MA, Vice Chairman, Professor, Department of Surgery, Section of Gastrointestinal Medicine and Department of Cellular and Molecular Physiology, Yale University School of Medicine; Director of Surgical Research, Department of Surgery, Yale-New Haven Hospital
John Geibel, MD, DSc, MA is a member of the following medical societies: American Gastroenterological Association, American Physiological Society, American Society of Nephrology, Association for Academic Surgery, International Society of Nephrology, New York Academy of Sciences, and Society for Surgery of the Alimentary Tract
Disclosure: AMGEN Royalty Other

 
 
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