What is an excavating wound?

From the Guidelines

An excavating wound is a type of wound characterized by tissue loss that creates a cavity or depression below the skin surface, often requiring specialized care to promote healing and prevent complications. This type of wound can occur due to various causes, including surgical debridement, as described in the guidelines on interventions to enhance healing of foot ulcers in people with diabetes (iwgdf 2023 update) 1. According to these guidelines, debridement involves the removal of dead and devitalised tissue from wounds to create a clean wound bed and promote wound healing.

Characteristics of Excavating Wounds

• Tissue loss creating a cavity or depression below the skin surface
• Can extend deep into subcutaneous tissues, muscle, or even to bone
• Common causes include surgical debridement, traumatic injuries, severe infections, or certain disease processes that cause tissue necrosis
• Require specialized care due to the risk of infection and complications in healing

Treatment and Healing Process

• Proper cleaning and packing the wound with appropriate dressing materials to absorb drainage and promote healing from the bottom up
• Regular assessment to monitor healing progress
• Healing occurs through a process called secondary intention, where granulation tissue gradually fills the cavity from the base upward before epithelialization occurs across the surface
• May require advanced wound care techniques, such as negative pressure wound therapy, to optimize healing conditions and prevent complications, as supported by the limited high-quality evidence available on debridement techniques 1.

Importance of Appropriate Care

Given the complexity and depth of excavating wounds, they often heal more slowly than superficial wounds. Therefore, it is crucial to follow evidence-based guidelines for their management, prioritizing techniques that promote a clean wound bed and facilitate the healing process, such as those discussed in the context of foot ulcers in people with diabetes 1.

From the Research

Definition of Excavating Wound

There are no research papers to assist in answering this question. The provided studies discuss negative pressure wound therapy, wound healing, and management of various types of wounds, but do not define or mention an "excavating wound" specifically.

Related Wound Types

• The studies mention different types of wounds, such as:
  • Chronic wounds 2
  • Acute wounds 2, 3
  • Diabetic foot ulcers 4, 2, 5
  • Pressure ulcers 4, 2
  • Venous leg ulcers 4
  • Deep cavity wounds 3
  • Infected wounds 6

Wound Management and Treatment

• Negative pressure wound therapy (NPWT) is discussed as a treatment option for various types of wounds 4, 2, 3, 6, 5
• Instillation therapy is mentioned as a technique used in conjunction with NPWT to cleanse the wound and promote healing 4, 3, 6, 5