Wound Care Workup

Updated: Apr 24, 2020
  • Author: Brian J Daley, MD, MBA, FACS, FCCP, CNSC; Chief Editor: Zubin J Panthaki, MD, CM, FACS, FRCSC  more...
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Workup

Laboratory Studies

The following tests may be useful to identify factors associated with wound development or those that can slow wound healing:

  • CBC count to assess for leukocytosis, anemia, and/or 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 abnormalities, especially if deep wound excision is required

  • Tissue cultures of wound to determine appropriate antibiotic therapy

Additional studies that may play a role in evaluating specific wound etiologies include vascular laboratory studies (eg, plethysmography, pulse-volume recordings [PVRs]) to assess the hemodynamic significance of arterial occlusive disease.

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Imaging Studies

Plain radiography, CT, and MRI may help in looking for underlying osseous abnormalities (including osteomyelitis), proximity of the wound to hardware, or foreign bodies.

Vascular ultrasonography may be indicated to evaluate for aneurysmal disease, arterial-occlusive disease, or deep venous occlusion.

In cases in which plain radiography or MRI are not diagnostic, bone scanning may be needed to evaluate for osteomyelitis. Technetium Tc 99m–labeled WBC scanning (Ceretec) has high specificity and sensitivity for osteomyelitis. However, it requires 24 hours for completion and it lacks anatomic detail.

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Diagnostic Procedures

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

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