Of the 1,592 days with. The wound was initially covered with a foam dressing. Interestingly, anomalies of the gluteal crease are the most commonly encountered findings in well neonates, with 1 study reporting an incidence of 24. generally gluteal cleft wounds that are linear in this way are caused from moisture, and would be classified as moisture associated damage. The gluteal cleft refers to the separation of the buttocks. hoping is going to go away. rapid heartbeat. L89. Remove side release films and gently smooth each side into place. A pressure injury develops as a result of unrelieved pressure between the sacral bone and the sitting or lying surface. Triad is an ideal dressing choice for difficult-to-dress wounds on wet or irregular surfaces. Figure 1: Example of periwound maceration. Read about recovery time, diagnostic tests, and prevention. the presence of a deep gluteal cleft as the etiology of the disease. The flap is then closed over the ‘shallowed’ valley and sutured to the side outside the cleft. In contrast to reconstruction of a large sacral soft tissue defect, options for reconstruction of a large gluteal soft tissue defect have seldom been discussed in the literature. 309 - other international versions of ICD-10 L89. The 2024 edition of ICD-10-CM L05. 2). Typically, pilonidal cysts occur after puberty. Intertriginous dermatitis mayPhysical examination shows a pilonidal cyst or sinus located beneath the skin, generally at the top of the gluteal cleft, at the level of the coccyx and/or the sacrum, 4 to 10 cm from the anus, in the midline, but often asymmetrical in shape. I know that I do not have an anal fissure or fistula becuase the open sore is located inside my gluteal cleft. To the Editor: Verrucous porokeratosis of the gluteal cleft is a rare skin condition that has distinct clinical and histologic features. The 2021 edition of ICD-10-CM M62. 1 The classic findings, found in 50% of cases, include perianal and peristomal skin tags, fistulae, perineal ulcers, linear ulcers (resembling knife cuts), abscesses, and fissures. 312 became effective on October 1, 2023. It’s beneath the sacrum and, ahem, “in the superior gluteal cleft. 322 became effective on October 1, 2023. This rash may burn or itch. On the dressing, print “P” for Preventative dressing and add the date that the dressing was applied. S31. 7% in the general population, more commonly affecting males (male to female ratio: 4:1) between the ages of 15 and 38 years [1-4]. 809A is grouped within Diagnostic Related Group(s) (MS-DRG v 41. A 55-year-old woman with CD and HS was referred to a dermatology clinic in July 2015 for evaluation of a peristomal rash. Showing 1-25: ICD-10-CM Diagnosis Code L02. Get free rules, notes, crosswalks, synonyms, history for ICD-10 code L98. Posterior pelvis and femur are exposed in the base of the wound. (C) The wound after 6 weeks. to the office each week for wound evaluations and dressing changes for failed surgical treatment of pilonidal disease, or for treatment of intentionally created. The following wounds are more prone to developing periwound moisture. 829A is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. This is the American ICD-10-CM version of S31. 9% of cases the wounds were not penetrating and in 6. In this article, we describe how PD is an acute, chronic, and recurring disease that requires clinicians. Excision and midline suture Wound closure in the midline is intended to shorten the mean duration of wound healing, yet the incidence of wound dehiscence is high, with reported rates varying from 14% to 74% ( 29 ). On day 14, he was extubated. Results: We reviewed records of 237 subjects, 151 women and 86 men, with a total of 572 buttock recurrences. The 2024 edition of ICD-10-CM S31. Press and smooth the dressing to ensure the entire dressing is in contact with. This is not noticed when your child has on clothing. S31. Buttock abscess. Monitor for fever; more extensive cellulitis. 0 Traumatic amputation at hip joint. However, the opening of the fistula tract may be present in the left costal margin, right iliac fossa, right groin, or right gluteal region. Excision and midline suture. Erythematous plaques in axillae - a. 001). A full thickness skin flap is mobilized across the gluteal cleft to create an off-midline closure (Fig. 06 [convert to ICD-9-CM] Epigastric swelling, mass or lump. Gluteal tendinitis; Gluteal tendonitis. (B) Sever all knee ligaments. 500 results found. The internet is a wonderful resourceThe Wound, Ostomy, and Continence Nurses Society ™ (WOCN ®) today announced that its application for new ICD-10-CM diagnosis codes for Moisture-Associated Skin Damage (MASD) has been approved by the ICD-10 Coordination and Maintenance Committee and will take effect on October 1. The area is prepped with an antiseptic solution and draped in a typical fashion. 8 may differ. This area is the groove between the buttocks that. 1 Historically, the concept of MASD arose from recognition that many skin lesions. Most patients say that the pain is minimal, and they only take analgesic pain medications for a few days. The rotating of tissue causes the gluteal cleft to shift. 04%, they are likely too common to be considered high risk. difficult-to-dress wounds with light-to-moderate exudate such as those near the gluteal cleft. 8 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Left untreated, the periwound will eventually break down and the wound will. 829A is a billable diagnosis code used to specify a medical diagnosis of unspecified open wound of left buttock, initial encounter. 039 Puncture wound without foreign body, unspecif. 2. 3) Excludes2: open wound of hip ( S71. Use secondary code (s) from Chapter 20, External causes of morbidity, to indicate cause of injury. She has authored numerous key publications and is a well-known lecturer in the areas of wound, ostomy and continence management, and professional practice for the WOC nurse. Psoriasis of the gluteal cleft known as the crease between the buttocks is not an easy symptom to treat. 4 became effective on October 1, 2023. gluteal cleft with associated midline pits. 4. 032A is grouped within Diagnostic Related Group(s) (MS-DRG v 41. Triad facilitates autolytic debridement to help manage necrotic tissue such as slough and eschar. The ICD code L05 is used to code Pilonidal cyst. As they fall apart, bacteria begin growing in the wound, and it appears as if infection caused the incision to separate – but actually it is the opposite. 9. Treatment may include cleaning and reclosing the wound and a course. The gluteal cleft is a common area for wound difficulties, and potential bacterial contamination, as well as persistent underlying seroma (common at two weeks post-op) can make this more than a superficial wound healing concern. In response to an initiative spearheaded by the Wound, Ostomy and Continence Nurses Society (WOCN), new diagnosis codes for moisture-associated skin damage (MASD) were added to the current version of the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM). The gluteal cleft is the groove running between each buttock, from the base of the spine to the perineum, which is the area between the anus and genitals. Click the card to flip 👆. Usually over a bony prominence. •Stable (dry, adherent, intact without erythema or fluctuance) eschar on the heels serves as “the body’s naturalGluteal cleft. S31. Wounds heal poorly in the deep, intergluteal natal cleft, for two reasons. 82 may differ. The patient is placed in the prone position, the gluteal cleft evaluated, and any adjacent hair trimmed using clippers. She. Gluteal Cleft stock photos are available in a. S. A pilonidal sinus affects the natal cleft, which is the top of the crease of the buttocks, just under the tailbone. Wound closure in the midline is intended to shorten the mean duration. Although evidence is lacking, clinical experience suggests that MASD requires more than moisture alone. (A) Incision from the gluteal cleft to popliteal fossa and guillotine distal shank amputation. The cyst is almost always near the tailbone at. The team of certified wound care nurses at this large integrated health system recognized that there was a 2-fold problem associated with their current protocol used to treat intergluteal cleft lesions. L05. 313 became effective on October 1, 2023. 82 - other international versions of ICD-10 S31. An incision 1/2″-3/4″ is best. A 63-year-old male with a 20-year history of a chronic, recurrent sacrococcygeal pilonidal cyst was referred to our outpatient clinic. It is important that the dressing ‘fits’ into the upper aspect of the gluteal cleft to ensure that the dressing is properly secured against incontinence episodes. A clean wound without surrounding cellulitis is an. S31. S72. 8 became effective on October 1, 2023. 819A is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Figure 1 Extent of the decubitus ulcer is shown. A pilonidal cyst can be extremely painful especially when sitting. And it may be necessary for two caregivers to assist with skin assessment in this patient population. ICD 10 code for Non-pressure chronic ulcer of buttock with unspecified severity. Applicable To. I was merely ruling out an Acute Anal Fissure by the Q and A, which is a tear in the anus and is very painful during passage of. (C) The wound after 6 weeks. The team of certified wound care nurses at this large integrated health system recognized that there was a 2-fold problem associated with their current protocol used to treat intergluteal cleft lesions. Usually asymptomatic; affects the head, neck, back, or. . Recurrence rates have been reported between 0% and 4. 5). This is the American ICD-10-CM version of Q82. The authors gathered clinical illustrations of gluteal cleft wounds and conducted a literature search as a basis for presentation to conference attendees, with the goal of gaining consensus. 1). The term pilonidal cyst comes from the Latin words, “pilus” (hair) and “nidus” (nest). There is a phlegmon in the most inferior wound at this time. Triad is easy to apply, and can be used on the wound or peri-wound skin. He had 3 previous operations from other surgeons, all of which failed. 9% [51, 52, 54]. ICD-10-CM Diagnosis Code M76. A comparison of the various surgical most effectively. 829S is a valid billable ICD-10 diagnosis code for Unspecified open wound of left buttock, sequela . Actually, that is not the case. People who are overweight and who have thick, stiff body hair are more likely to develop pilonidal disease. 3. A finger sweep was conducted that showed the subcu tissue. Collection of data that characterizes the status of a wound and the surrounding periwound skin. Affected individuals. ”. For example, the pannus or abdominal skin folds, inner gluteal cleft, and axillae are some common anatomical locations of ITD. 317 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. However, the. The new natal cleft is less deep and smoothly transitions down toward the anus. 1% there were penetrating wounds. Irregular surfaces could include the gluteal cleft, coccyx, perineum, buttocks, groin, face, hands, feet and other areas. Then, the surgical wound is closed by rotating other tissue to cover the area. Remove femur after distal mobilization and disarticulate hip posteriorly through the decubitus ulcer. Sometimes called the Cleft procedure, this surgery removes all the skin covering the involved area. For more information, call 800 -840-9041or visit our website at Documenting Wounds (Part 2 - Anatomic Location) Consistency in wound documentation is of utmost. Intertrigo is a superficial inflammatory dermatitis occurring on two closely opposed skin surfaces as a result of moisture, friction, and lack of ventilation. 0):. Patient has recurrence of pilonidal disease. The small contralateral decubitus ulcer was treated. This is a major advantage compared to the VRAM or conventional gluteal flaps (e. The authors present results of surgical treatment of 98 patients with gluteal wounds. Sometimes, there is only a cutaneous dimple in the midline above the gluteal cleft. Gluteal flaps can be used as split gluteal flaps, V to Y advancement gluteal perforator flaps. Typically, pilonidal cysts occur after puberty. On day 6, gluteal erythema was noted, and the wound care team recommended topical medication, attributing erythema to occlusion and moisture. Chronic ulcer of buttock limited to skin layer; Chronic ulcer of buttock, breakdown of skin; ICD-10-CM L98. Body habitus may contribute to additional intertriginous sites, such as inframammary skin and. Bone cultures grew Morganella morganii with pathology consistent with acute osteomyelitis. 9 became effective on October 1, 2023. By sealing the affected area with a protective film, the skin can get to work recovering. Bodily secretions. This is the American ICD-10-CM version of S30. Small amounts of pain that go away after a few days or a week are normal, but deep gluteal syndrome causes pain that is usually more severe and doesn’t go away, even with rest and basic care at home. Though MRI is fully capable of imaging soft tissue structures, the exam requires a longer amount of time to complete than other modalities. This is the American ICD-10-CM version of S31. It was co-founded by the Initiative Chronische Wunden (ICW, Chronic wound initiative, Germany), the Austrian Wound Association (AWA, Austria) and the Swiss Association for Wound Care (SAfW, Switzerland). 313 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Her skin examination revealed multiple bullous lesions in the perirectal area involving the gluteal cleft and both. Affected individuals – typically obese, sedentary men with excessive body hair and a deep gluteal cleft – may be asymptomatic or present with mild local. What is gluteal cleft wound? Toward the bottom of your spine, where your buttocks split, is a crease called the gluteal cleft. The wound deteriorated with some of the dark tissue forming eschar within three days. It affects about 70,000 people in the US annually and is more common in men than women. Packing: if an abscess or open wound has gauze dressings inserted into it and changed daily, this is referred to as “packing”. Ultrapotent or mid-potent corticosteroid creams alleviated the symptoms only slightly when used twice a day for 2–3 weeks. PDF | The damaging effects of moisture, pressure, friction, and shear on human tissue are well-known among wound care experts. "the difference perianal and gluteal abscess. There is no wound packing and. . How does Triad work?S30. For such conditions, ICD-10-CM has a coding convention that requires the underlying condition be sequenced first followed by the manifestation. 313 may differ. Abscess cultures from the previous admission were reviewed and noted to have grown Escherichia coli and clostridium species. The gluteal cleft and the gluteal fold both occur normally in humans. 2. 317 - other international versions of ICD-10 L03. Patients had undergone a total of 141 operations with wounds still open for a combined total of 252 years. hair in the gluteal cleft. Hyperglycemia on last blood sugar check; patient with poorly controlled type 2 DM. All patients with a documented herpes lesion on the buttocks, upper thigh or gluteal cleft ("buttock recurrence") and concomitant viral cultures from genital sites including the perianal region were eligible. The gluteal cleft is just above the anus. wound without the need for a secondary dressing. Pilonidal disease refers to a subcutaneous infection occurring in the upper half of the gluteal cleft. The first step to achieving consistent documentation is to correctly identify wound etiology. Injuries to the abdomen, lower back, lumbar spine, pelvis and external genitals. If there is difficulty lifting the film border, apply tape to the edge of the dressing and use the tape to lift. Sometimes called the Cleft procedure, this surgery removes all the skin covering the involved area. Approximate Synonyms. The superior tip of the intergluteal cleft. Remove femur after distal mobilization and disarticulate hip posteriorly through the decubitus ulcer. The wound exam showed a partial-thickness wound just above the cleft of his buttocks roughly 1. How is the recovery for the cleft-lift procedure? Compared to the standard wide excision, it is a much easier recovery. The recovery from cleft-lift is an easier recoveries when compared to the other procedures for pilonidal disease. 05 significance level and with 80% power. The intergluteal cleft or just gluteal cleft, also known by a number of synonyms, including natal cleft, butt crack, and cluneal cleft, is the groove between the buttocks that runs from just below the sacrum to the perineum, so named because it forms the visible border between the external rounded protrusions of the gluteus maximus muscles. Puncture wound of left great toe; ICD-10-CM S91. [161, 162] The gluteal thigh rotation flap is an axial flap based on the inferior gluteal artery. 820A. 821A is grouped within Diagnostic Related Group(s) (MS-DRG v 41. KEYWORDS: abscess, female, gluteal cleft, pilonidal cyst, pilonidal disease, women’s health P ilonidal disease (PD) is defined as a condition of the skin and subcutaneous tissue at or near the natal, or intergluteal, cleft (see Supplementary Figure S1). In its. Colorectal Dis. 322 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. 4 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Main Outcome Measures Number healed, time to healing, number of operations required. 31 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. 322 - other international versions of ICD-10 L89. S31. L02. Published by Lippincott. 1 The latter name, although. Stage 2- The 3 P's! Pink, Partial, Painful! Stage 2 wounds are partial thickness and often resemble a very shallow ulcer with a reddish-pink wound bed. Sometimes called the Cleft procedure, this surgery removes all the skin covering the involved area. ICD 10 code for Blister (nonthermal) of lower back and pelvis, initial encounter. 323 became effective on October 1, 2023. 604 Trauma to the skin, subcutaneous tissue and breast with mcc; 605 Trauma to the skin, subcutaneous tissue and breast without mcc; 963 Other multiple significant trauma with mcc; 964 Other multiple. Ten blade was used to remove and debride the. Excludes1: traumatic amputation of part of abdomen, lower back and pelvis ( S38. Epigastric mass; Epigastric swelling, mass. 3 Loose hairs trapped in the natal cleft traumatize and penetrate the skin, creating a foreign body reaction that may ultimately lead to formation of midline pits and, in some cases, secondary infection. The code is valid during the fiscal year 2023 from October 01, 2022 through September 30, 2023 for the submission of HIPAA-covered transactions. After washing, you need to ensure that the skin is thoroughly dried. Click the card to flip 👆. Best answers. Azathioprine 50 mg once daily was added to her longstanding. 4 The spectrum of pilonidal disease presentation varies from a chronic cyst and/or sinus with persistent drainage and/ Pilonidal disease is a clinical diagnosis based on history, physical exam (including anorectal exam), and evaluation of symptoms and risk factors. functions of the skin. 1. It may be due to an allergy, a virus, a fungal or bacterial infection, or another health condition. A stage 2 pressure ulcer may appear as a shallow, crater-like wound or a blister containing a clear or yellow fluid. This means that the butt crack will appear off-center. Both the biceps femoris flap and the hamstring. Gluteal cleft and coccyx stage 3 with DTPI in wound bed: Coccyx: Wound improved and was 1. The 2024 edition of ICD-10-CM L89. Stage 1- A non blanching red area, that does not go away. 353 results found. Nevertheless,. Usually over a bony prominence. It is a visible border separating ass into two parts. The. By flattening the cleft, recurrence is minimized. gallstones, kidney stones, liver disease, diseases of the female reproductive, and. Moisture-associated skin damage and incontinence-associated dermatitis frequently occur in these two areas (Doughty & McNichol, 2016). Four days later, the patient underwent a repeat I&D of the gluteal flaps with a delayed partial closure of the bilateral gluteal fasciocutaneous flaps, left gluteal, and incisional wound vacuum placement, and sacral bone biopsy and culture. 573 Skin graft for skin ulcer or cellulitis with mcc; 574 Skin graft for skin ulcer or cellulitis with cc; 575 Skin graft for skin ulcer or cellulitis without cc/mcc; 592 Skin ulcers with mcc; 593 Skin ulcers with cc; 594. A deep natal cleft is associated with PSD and should be considered the cause of the condition. This can then lead to the subsequent formation of a subcutaneous abscess from a persistent folliculitis. Periwound moisture-associated dermatitis occurs when the skin adjacent to a chronic wound becomes exposed to exudate or toxins from bacteria in the wound bed, causing inflammation and erosion. Polyglactin 0 sutures were used to approximate both gluteus muscles and fasciae together covering the inter-gluteal cleft. The primary intertriginous skin areas include the groin folds, axillae, and gluteal cleft. The first is the frictional motion of the deep cleft, which creates continuous irritation to the healing wound; the second is the midline nature of the wound, which is a product of constant lateral traction during sitting. 4 When the skin is moist, it is. L89. 032 Puncture wound without foreign body, left hip. on the WOCN Society's wound care forum and to an e-mail sent to members of the WOCN Iowa Affiliate. Pilonidal disease is an acute or chronic infection in the subcutaneous fatty tissue, mainly in the natal (intergluteal) cleft. Carefully lift the dressing edges (filmICD-10. When seated and standing, the buttocks clamp shut and create an air seal that traps debris and bacteria in the area, leading to slower healing. 0):. Gluteal implants are an effective and predictable way to remodel the buttocks. These codes are used. 11,12 In many of the sacral-area reconstruction cases, the patients are looking for improvement in quality of life, or simply a closed wound situation. The separation allowed bacterial. Figure 3. . (A) The patient in the prone position. There are several disorders that can affect the intergluteal cleft including inverse psoriasis , [2] [3] caudal regression syndrome , [4] and pilonidal disease . If the area of recurrence is relatively small with a shallow intergluteal cleft, open the tracts. 829A became effective on October 1, 2023. Open wound of cheek; ICD-10-CM S01. Shave, Feet CPT 11305 - Shaving of epidermal or dermal lesion, single lesion, scalp, neck, hands, feet, genitalia; lesion diameter 0. Unspecified open wound of left buttock, initial encounter. Wound care is an essential role for nurses in the management of PD. (71 g) 12 1967 6 oz. Most often it occurs between puberty and age 40. Share this: “Wound” and “ulcer” are 2 major categories of wounds from the ICD-10 coding perspective – the acute form is categorized as wound and the chronic form is categorized as ulcer. Open wound of abdomen, lower back, pelvis and external genitals (S31) Open wound of left buttock (S31. Triad Hydrophilic Wound Dressing offers a unique approach to wound management and wound treatment. Pilonidal cysts and sinuses are a spectrum of pilonidal disease conditions that occur between the buttocks (gluteal crease or cleft) near the tailbone in the lower back. The prevalence of IAD varies widely depending upon the setting. Intertrigo in babies requires special care because the affected skin area is so delicate. Some symptoms associated with stage 2 pressure ulcers include: pain. 1,4 However, some believe all gluteal cleft anomalies other than dimples warrant. IP is usually found in the groins, vulva, axillae, submammary folds, gluteal cleft, navel, intergluteal crease, penis, lips, and web spaces. Excision: removal of the involved area. Gluteal cleft is the vertical partition which separates buttocks. The International Wound Journal is a clinically relevant wound care journal covering the prevention and treatment of wounds and associated skin conditions. It is a procedure for pilonidal disease that removes all of the existing cysts, sinus tracts and open wounds, and flattens the gluteal cleft. Plastics is doing the closure. a moisture lesion will not heal if treatedHere are some of the most common symptoms of herpes on the buttocks: skin feels itchy or burns before bumps or blisters appear. 2. Introduction. One central aim of Wund. Therefore, the first option for reconstruction of ischial wounds is the gluteal thigh rotation flap, which does not preclude the future use of the inferior portion of the gluteus maximus muscle. Buttocks: Plaque or inverse psoriasis causes itching, cracking, scaly, and bleeding skin on your buttocks or gluteal cleft. 819A - other international versions of ICD-10. A pilonidal cyst (also called pilonidal cyst disease, intergluteal pilonidal disease or pilonidal sinus) is a skin condition that happens in the crease of the buttocks — anywhere from the tailbone to the anus. S31. Our preference for management of chronic pilonidal disease is the Bascom cleft lift procedure, with minor modifications to the technique as originally described (See Video [online], which displays the cleft lift procedure favored by the senior authors for management of pilonidal disease). Severe. -). A rash is any area of irritated or swollen skin on your. What is the diagnosis code for a stage 3 gluteal cleft pressure ulcer? Are two codes required in order to capture the correct location since the gluteal cleft appears to be between both sides of the buttocks?. Intertrigo is a common inflammatory skin condition that is caused by skin-to-skin friction (rubbing) that is intensified by heat and moisture. The patient is able to sit, has full pelvic range of motion, and sexual intercourse. S72. 819A became effective on October 1, 2023. This is the American ICD-10-CM version of L89. Contact dermatitis is an inflammatory skin response to an allergen, chemical, or other agent. The procedure consisted of excision of the sinus tracts, cysts, and open wounds; raising a skin and subcutaneous tissue flap; and flattening the gluteal cleft. Of the 107 non-Hispanic whites who had perianal nevi, 1 or more nevi were detected in the anal margin in 21. Intertrigo occurs more easily in environments that are hot and humid. Without the valley and divots, debris and hairs can’t collect. 0):. Pilonidal cysts affect mainly postpubertal adolescents and young adults, affecting 2–3 per 5,000 individuals. On day 15, he developed atrial fibrillation with RVR and was started on IV heparin, but this was discontinued because of epistaxis and haematuria. In this article, we describe how PD is an acute, chronic, and recurring disease that requires clinicians to be vigilant in assessments, treatments, therapies, referrals, and patient. An asymmetrical ellipse of skin at the right or left side of the gluteal cleft (depending on the location of the pits or sinuses) was marked and, after wide. Intervention The deep gluteal cleft was reshaped with a skin flap. 829A is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. With the cleft lift procedure,. :) Documentation is key. 5% Marcaine with epinephrine, we made a vertical incision along the gluteal cleft connecting the two wounds. Without. J Wound Ostomy Continence Nurs. Intertriginous skin, also known as skin folds, are sites in which opposing skin surfaces come into contact while at rest, resulting in chronic skin occlusion. It separates the two glutes (and the buttocks) from each other and extends downwards from the third or the fourth sacral spine, deepening as it goes inferiorly. 8%. This is a result of too much exudate that hasn’t been properly managed. And it may be necessary for two caregivers to assist with skin assessment in this patient population. The goal is to achieve healing in the simplest and least complicated way possible.