What a wound assessment covers
Wound assessment and measurement is the starting point for every wound care plan. Before the treating clinician chooses a dressing or orders a test, they need a clear picture of the wound and of the person who has it. Gateway arranges these visits with partner clinicians across Greater St. Louis and the Metro East.
During an assessment, the treating clinician may look at:
- Location and likely cause, such as pressure, poor circulation, swelling, diabetes, surgery or injury
- Size, including length, width and depth
- Tissue in the wound, such as moist red tissue, a yellow or tan film, or dark, dry tissue
- Edges, including any tunnels or pockets under the skin
- Drainage, including how much, what color and whether there is an odor
- Skin around the wound, including redness, swelling, warmth or skin that looks soggy
- Pain, both at rest and during dressing changes
How wounds are measured
Most wounds are measured in centimeters. The clinician records length, width and depth, and notes any spaces that extend under the skin beyond what you can see. Those spaces are often described like the face of a clock, with 12 o’clock pointing toward the head.
Measuring the same way each visit matters as much as the numbers, so the clinician keeps your position and the method consistent. Our guide to understanding wound measurements explains terms you may see in a visit note.
How photos help track progress
With your permission, the clinician may photograph the wound at each visit. A photo captures things numbers cannot, such as tissue color, the shape of the edges and the look of the nearby skin.
Photos become part of the record kept by the treating practice. Placed side by side, they show other members of your care team what the clinician saw.
Why the trend matters more than one number
A single measurement is a snapshot. A series of measurements shows direction: smaller, larger or unchanged. The treating clinician uses that trend to decide whether to keep the plan, change it or look for something that is holding healing back.
Numbers can be confusing on their own, so ask what each change means for you. Size is only one part of the answer.
What else the clinician may review
A wound reflects the health of the whole person. The treating clinician may ask about blood sugar, circulation, swelling, nutrition, medications and how much time you spend in a bed or chair. When the wound is on a leg or foot, they may also check pulses and sensation.
Some of these issues belong with primary care. When they do, Gateway helps both sides share information so that primary care and wound care work together.
How Gateway arranges assessments at home and in facilities
For a home visit, Gateway takes the request, gathers available records and works with the treating practice to schedule the visit. Availability is confirmed by location and care setting. The clinician comes to you through mobile wound care, which helps when travel is hard.
In skilled nursing, assisted living, memory care and rehabilitation settings, assessments often happen during scheduled facility wound rounds. Nursing staff describe what they have seen since the last visit, and the clinician’s measurements and orders go back to the facility for its records.
How findings reach the rest of the care team
An assessment is only useful if the right people see it. As part of our care coordination work, Gateway helps route visit notes, measurements and new orders to the people involved. That may include your primary care clinician, a home health agency, facility nurses or a specialist.
Changes to report between visits
You see the wound more often than anyone. Tell the treating clinician’s office if you notice:
- The wound looks larger or deeper
- More drainage, a change in its color or a new odor
- Redness, warmth or swelling spreading into nearby skin
- New or worsening pain
- Fever or chills
Call 911 for an emergency, such as heavy bleeding that will not stop, trouble breathing or sudden confusion. Gateway is not an emergency service.
How to start
Patients, family members and caregivers can call 314-325-0126 or request care online, with or without a referral. The form asks only for contact details, so please save medical details for the phone call. Facilities and practices can refer a patient or fax a referral to 314-786-7966.
Common questions
How often will my wound be measured?
The treating clinician sets the schedule based on the wound and the care setting. Many wounds are measured at each clinician visit, and facilities commonly record measurements on a regular schedule in between. A wound may also be measured again when something changes, such as new drainage.
Why did my wound measure larger after the last visit?
There are several possible reasons. The clinician may have removed unhealthy tissue, which can reveal the true size of the wound. A pocket under the skin may have opened. Or the wound may be getting worse. Only the treating clinician can tell which applies to you, so ask them to explain the change and what it means for the plan.
Can I take my own photos of the wound?
Ask the treating clinician first. Some welcome photos taken during a planned dressing change, and others prefer to rely on their own. Do not remove a dressing early just to take a picture. Our guide on telehealth and wound photos covers lighting, angles and how to share images privately.
What do tunneling and undermining mean?
Both words describe space under the skin that you cannot see from the surface. Tunneling is a narrow channel that runs in one direction. Undermining is a wider shelf beneath the wound edge. The clinician measures both because they affect how the wound is dressed and how healing is tracked. Read more about tunneling and undermining wounds.
Related pages
General information to help you talk with your own clinician. It is not medical advice, and the treating clinician makes every clinical decision. For a medical emergency, call 911.