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Common PU Locations
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Wound 1
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Wound 1
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Location
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Location Comment
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Wound Duration
• • •
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Wound Duration Comment
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Type
• • •
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Type Comment
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Wound Pressure Stage/DFU Grade
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Wound Stage/Grade Comment
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Thickness
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Thickness Comment
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Size in cm (LxWxD)
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Size Comment
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Previous Size
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Previous Size Comment
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Undermining/Tunneling
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Undermining/Tunneling Comment
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Wound Bed
• • •
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Granular %
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Fibrotic %
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Slough %
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Eschar %
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Wound Bed Comment
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Visible Anatomical Structures
• • •
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Visible Anatomical Structures Comment
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Wound Edges
• • •
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Wound Edges Comment
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Surrounding Tissue
• • •
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Surrounding Tissue Comment
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Exudate Amount
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Exudate Amount Comment
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Exudate Type
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Exudate Type Comment
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Odor
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Odor Type
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Concern for Infection
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Concern for Infection Comment
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Wound Progression
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Wound Progression Comment
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Wound Care Performed
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Wound cleansed
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Wound Cleaning Comment
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Sharp Debridement Contraindications
• • •
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Debridement Contraindications Comment
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Sharp Debridement Wound 1
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Debridement Freewrite
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Topical Numbing Cream
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Post Debridement Measurement (LxWxD) cm:
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Debridement Type
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Tissue Removed
• • •
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Tissue Removed Comment
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Wound Bed Post-Debridement
• • •
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Granular %
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Fibrotic %
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Slough %
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Eschar %
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Wound Bed Comment
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Instrument(s) Used
• • •
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Instrument(s) Used Comment
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Blood Loss
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Pressure Applied
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Primary Dressing(s)
• • •
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Secondary Dressing(s)
• • •
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Dressings Freewrite
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Wound 2
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Wound 2
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Location
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Location Comment
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Wound Duration
• • •
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Wound Duration Comment
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Type
• • •
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Type Comment
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Wound Pressure Stage/DFU Grade
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Wound Stage/Grade Comment
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Thickness
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Thickness Comment
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Size in cm (LxWxD)
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Size Comment
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Previous Size
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Previous Size Comment
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Undermining/Tunneling
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Undermining/Tunneling Comment
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Wound Bed
• • •
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Granular %
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Fibrotic %
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Slough %
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Eschar %
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Wound Bed Comment
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Visible Anatomical Structures
• • •
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Visible Anatomical Structures Comment
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Wound Edges
• • •
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Wound Edges Comment
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Surrounding Tissue
• • •
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Surrounding Tissue Comment
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Exudate Amount
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Exudate Amount Comment
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Exudate Type
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Exudate Type Comment
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Odor
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Odor Type
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Concern for Infection
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Concern for Infection Comment
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Wound Progression
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Wound Progression Comment
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Wound Care Performed
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Wound cleansed
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Wound Cleaning Comment
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Sharp Debridement Contraindications
• • •
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Debridement Contraindications Comment
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Sharp Debridement Wound 2
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Debridement Freewrite
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Topical Numbing Cream
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Post Debridement Measurement (LxWxD) cm:
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Debridement Type
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Tissue Removed
• • •
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Tissue Removed Comment
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Wound Bed Post-Debridement
• • •
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Granular %
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Fibrotic %
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Slough %
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Eschar %
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Wound Bed Comment
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Instrument(s) Used
• • •
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Instrument(s) Used Comment
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Blood Loss
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Pressure Applied
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Primary Dressing(s)
• • •
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Secondary Dressing(s)
• • •
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Dressings Freewrite
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Wound 3
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Wound 3
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Location
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Location Comment
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Wound Duration
• • •
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Wound Duration Comment
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Type
• • •
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Type Comment
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Wound Pressure Stage/DFU Grade
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Wound Stage/Grade Comment
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Thickness
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Thickness Comment
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Size in cm (LxWxD)
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Size Comment
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Previous Size
|
Previous Size Comment
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|
Undermining/Tunneling
|
Undermining/Tunneling Comment
|
|
Wound Bed
• • •
|
|
|
Granular %
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Fibrotic %
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Slough %
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Eschar %
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Wound Bed Comment
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Visible Anatomical Structures
• • •
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Visible Anatomical Structures Comment
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Wound Edges
• • •
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Wound Edges Comment
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Surrounding Tissue
• • •
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Surrounding Tissue Comment
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Exudate Amount
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Exudate Amount Comment
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Exudate Type
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Exudate Type Comment
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Odor
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Odor Type
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Concern for Infection
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Concern for Infection Comment
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Wound Progression
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Wound Progression Comment
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Wound Care Performed
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Wound cleansed
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Wound Cleaning Comment
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Sharp Debridement Contraindications
• • •
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Debridement Contraindications Comment
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Sharp Debridement Wound 3
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Debridement Freewrite
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Topical Numbing Cream
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|
Post Debridement Measurement (LxWxD) cm:
|
Debridement Type
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|
Tissue Removed
• • •
|
Tissue Removed Comment
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Wound Bed Post-Debridement
• • •
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|
|
Granular %
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Fibrotic %
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Slough %
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Eschar %
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|
Wound Bed Comment
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Instrument(s) Used
• • •
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Instrument(s) Used Comment
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Blood Loss
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Pressure Applied
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Primary Dressing(s)
• • •
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Secondary Dressing(s)
• • •
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Dressings Freewrite
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Wound 4
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Wound 4
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Location
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Location Comment
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Wound Duration
• • •
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Wound Duration Comment
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Type
• • •
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Type Comment
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Wound Pressure Stage/DFU Grade
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Wound Stage/Grade Comment
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|
Thickness
|
Thickness Comment
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|
Size in cm (LxWxD)
|
Size Comment
|
|
Previous Size
|
Previous Size Comment
|
|
Undermining/Tunneling
|
Undermining/Tunneling Comment
|
|
Wound Bed
• • •
|
|
|
Granular %
|
Fibrotic %
|
|
Slough %
|
Eschar %
|
|
Wound Bed Comment
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|
|
Visible Anatomical Structures
• • •
|
Visible Anatomical Structures Comment
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|
Wound Edges
• • •
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Wound Edges Comment
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|
Surrounding Tissue
• • •
|
Surrounding Tissue Comment
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|
Exudate Amount
|
Exudate Amount Comment
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Exudate Type
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Exudate Type Comment
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Odor
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Odor Type
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Concern for Infection
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Concern for Infection Comment
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Wound Progression
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Wound Progression Comment
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Wound Care Performed
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Wound cleansed
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Wound Cleaning Comment
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Sharp Debridement Contraindications
• • •
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Debridement Contraindications Comment
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Sharp Debridement Wound 4
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Debridement Freewrite
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Topical Numbing Cream
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|
|
Post Debridement Measurement (LxWxD) cm:
|
Debridement Type
|
|
Tissue Removed
• • •
|
Tissue Removed Comment
|
|
Wound Bed Post-Debridement
• • •
|
|
|
Granular %
|
Fibrotic %
|
|
Slough %
|
Eschar %
|
|
Wound Bed Comment
|
|
|
Instrument(s) Used
• • •
|
Instrument(s) Used Comment
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|
Blood Loss
|
Pressure Applied
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Primary Dressing(s)
• • •
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Secondary Dressing(s)
• • •
|
|
Dressings Freewrite
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Wound 5
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Wound 5
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Location
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Location Comment
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Wound Duration
• • •
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Wound Duration Comment
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Type
• • •
|
Type Comment
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|
Wound Pressure Stage/DFU Grade
|
Wound Stage/Grade Comment
|
|
Thickness
|
Thickness Comment
|
|
Size in cm (LxWxD)
|
Size Comment
|
|
Previous Size
|
Previous Size Comment
|
|
Undermining/Tunneling
|
Undermining/Tunneling Comment
|
|
Wound Bed
• • •
|
|
|
Granular %
|
Fibrotic %
|
|
Slough %
|
Eschar %
|
|
Wound Bed Comment
|
|
|
Visible Anatomical Structures
• • •
|
Visible Anatomical Structures Comment
|
|
Wound Edges
• • •
|
Wound Edges Comment
|
|
Surrounding Tissue
• • •
|
Surrounding Tissue Comment
|
|
Exudate Amount
|
Exudate Amount Comment
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|
Exudate Type
|
Exudate Type Comment
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Odor
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Odor Type
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Concern for Infection
|
Concern for Infection Comment
|
|
Wound Progression
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Wound Progression Comment
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|
Wound Care Performed
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Wound cleansed
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Wound Cleaning Comment
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Sharp Debridement Contraindications
• • •
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Debridement Contraindications Comment
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Sharp Debridement Wound 5
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Debridement Freewrite
|
|
Topical Numbing Cream
|
|
|
Post Debridement Measurement (LxWxD) cm:
|
Debridement Type
|
|
Tissue Removed
• • •
|
Tissue Removed Comment
|
|
Wound Bed Post-Debridement
• • •
|
|
|
Granular %
|
Fibrotic %
|
|
Slough %
|
Eschar %
|
|
Wound Bed Comment
|
|
|
Instrument(s) Used
• • •
|
Instrument(s) Used Comment
|
|
Blood Loss
|
Pressure Applied
|
|
Primary Dressing(s)
• • •
|
Secondary Dressing(s)
• • •
|
|
Dressings Freewrite
|
|
