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Appendix 8: Initial Wound Assessment and Treatment Plan

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    AMA Citation
    Initial Wound Assessment and Treatment Plan. In: McCulloch JM, Kloth LC. McCulloch J.M., Kloth L.C. Eds. Joseph M. McCulloch, and Luther C. Kloth.eds. Wound Healing Evidence-Based Management, 4e New York, NY: McGraw-Hill; . http://fadavispt.mhmedical.com/content.aspx?bookid=1954&sectionid=146788783. Accessed February 24, 2019.
    MLA Citation
    . "Initial Wound Assessment and Treatment Plan." Wound Healing Evidence-Based Management, 4e McCulloch JM, Kloth LC. McCulloch J.M., Kloth L.C. Eds. Joseph M. McCulloch, and Luther C. Kloth. New York, NY: McGraw-Hill, , http://fadavispt.mhmedical.com/content.aspx?bookid=1954&sectionid=146788783.

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Introduction

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Patient Name: Date of Evaluation:
Location:
Type:
Measurements (Length x Width x Depth):
Wound Base:
Signs/Symptoms of Infection (Yes/No):
Girth Measures:
Sensation:
Peripheral Pulses:
Other Tests (TCP02, Vascular Studies, X-Rays, Labs, etc.):
Consultations (MD, Rehab, Social Services, Home Health, Diabetes Education, etc.):

Treatment Plan (include plan, DME, home dressing supplies):

1.

2.

3.

4.

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6.

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