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Old 08-08-2009, 06:11 PM
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Default Wounds cannot be staged ~ Only Pressure Ulcers

Wounds are not stageable. Oasis will kick them back. Only pressure ulcers are stageable. Any pressure ulcer with eschar is also considered non-stageable.

More important things to keep in mind when charting wounds.


1. A surgical incision is not a wound unless it dehisces

2. Document:
  • anatomical position i.e. lateral left leg
  • wound bed, type of tissue that is exposed
  • wound exudate, odor, amount, consistency
  • color and temperature of peri wound area
  • presence of edema and amount
  • pain rating
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Old 08-08-2009, 07:58 PM
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For wounds, you can classify them as partial thickness (very shallow) or full thickness.
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Old 08-08-2009, 09:34 PM
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Quote:
Originally Posted by Diary View Post
For wounds, you can classify them as partial thickness (very shallow) or full thickness.

Wounds or burns?
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Old 08-08-2009, 10:22 PM
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On our OASIS it asks how many surgical wounds the pt has.


What bugs me is when someone tries to stage a stasis ulcer.
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Old 08-08-2009, 10:33 PM
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Please elaborate on "stasis" wound... yeah I know but I rarely saw them in the hospital. Forgive my ignorance.
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Old 08-08-2009, 10:54 PM
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Quote:
Originally Posted by HhRNhhr View Post
On our OASIS it asks how many surgical wounds the pt has

Everyone's Oasis set is identical.

Good old M0482. Does this patient have a surgical wound?

Medicare says surgical incisions are not wounds, they ask does the patient have a surgical wound.

Those that qualify as a surgical wound:

Orthopedic pin sites, central line sites, stapled or sutured incisions
Mediport site and other implanted infusion device or vascular access device when initially
implanted and as long as it is in place. Device does not need to be functional or accessed
at a particular frequency. These are central lines placed by a surgical procedure.
Peritoneal dialysis catheter, AV shunt
Wounds with drains
Wound created by a surgical procedure in which a drain is placed and after the drain is
pulled until it heals and becomes a scar
Surgical incision with well approximated edges and a scab (i.e., crust) from dried blood or
tissue fluid
Muscle flap to surgically replace pressure ulcer
Gastrostomy closed by a surgical "take down" procedure
A shave, punch or excisional biopsy to remove and/or diagnose skin lesions
Abscess treated by incision and drainage with placement of a drain
Surgical repair of a traumatic injury
Arthrocentesis site when a surgical procedure is performed by arthroscopy


Those that are excluded as surgical wounds:

Surgical wounds resulting in scar or keloid formation
Debridement or the placement of skin graft
PICC lines (peripherally inserted)
Gastrostomy allowed to close on its own without surgical intervention
Pressure ulcers treated by surgical debridement
Pressure ulcers treated with a skin graft
Recent healed surgical wounds with well approximated edges, complete epithelialization, no
drainage, edema or signs of infection and evidence of scar/keloid formation
Suturing of a traumatic laceration
Abscess treated by incision and drainage without placement of a drain
Cataract surgery or a gynecological surgical procedure via a vaginal approach (wound is not
of the integument)
Aspiration of fluid by needle without placement of a drain
Cardiac catheterization performed by needle puncture
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Old 08-08-2009, 10:59 PM
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Quote:
Originally Posted by Haunted View Post
Please elaborate on "stasis" wound... yeah I know but I rarely saw them in the hospital. Forgive my ignorance.
MO486 Does this patient have a statis ulcer?

A response of “Yes” identifies the presence of an ulcer caused by inadequate venous circulation in the area affected (usually lower legs). This lesion is often associated with stasis dermatitis. Stasis ulcers do not include arterial circulatory lesions or arterial ulcers.



Results from disturbance in the forward flow of blood in the lower extremities
May occur in presence of stasis dermatitis, brown/black discoloration of the LE or non-pitting
(brawny) edema
Usually located medial aspect of lower extremity and ankle, superior to medial malleolus
and seldom, if ever, on foot or above knee
Appearance: irregular wound margins, color of base ruddy, granulation frequently present,
shallow, superficial crater, exudate is moderate to heavy
Surrounding skin with edema, possible induration, cellulitis
Associated with minimal pain
“Counted” even if it has a scab, crust or necrotic tissue

Treated with a skin graft remains a stasis ulcer
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Old 08-09-2009, 08:50 AM
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Yes wounds as well.
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Old 08-09-2009, 09:02 AM
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Alllllllll good info ladies fank's you so much th_queendance
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