1. Introduction Medical illustrators are frequently asked to produce photographic documentation of skin conditions, described largely as ‘wounds’. Under the blanket terminology of ‘wound’, there are numerous classifications that are used to further define the wound type, which provide clinicians with more significant clinical information from which to determine a specific care plan for the patient. Photographs of a wound are often requested by clinicians to support the patient care plan by providing a visual aid to monitor wound progression over a period of time; the intervals for photography are dependent upon the type of wound.
Acute wounds typically progress more quickly and should be photographed at each dressing change. Chronic wounds develop more slowly therefore there is little benefit to photographing this type of wound any more frequently than every 2-4 weeks otherwise evaluation of progress will be made more difficult (local guidelines for frequency of photography should be followed). It is important however, to photograph a wound if any significant changes occur as this may have implications upon the course of treatment. Although there are many types of wounds, some of those that medical illustrators may commonly be asked to photograph can include:
page 4 Ulcer an open sore on an external or internal surface of the body, caused by a break in the skin or mucous membrane. Ulcers range from small, painful sores in the mouth (canker sores) to pressure sores, diabetic foot ulcers, corneal ulcers and serious lesions of the stomach (gastric ulcers). Surgical a cut or incision created during a surgical procedure in order to treat a wound condition. Abrasion also referred to as a scrape or a graze. An abrasion is a shearing or friction injury that results in a scraping or rubbing away of the outermost layers of skin. Sinus a tract to the surface of the skin from an abscess or some sort of wound irritant material or foreign body (eg.
sutures) which becomes infected. Sinus tracts can occur in various conditions including hidradenitis suppurativa (a skin condition that causes abscesses and scarring, generally affecting the groin, armpits, buttocks and beneath the breasts), pressure ulcers, abdominal surgery in the morbidly obese and pilonidal disease. Bite wound an injury inflicted by the teeth of a human or animal, ranging from superficial scratches to puncture wounds, crush injuries, major tears and degloving. Human bites can be classified further into actual bites and clenched fist injuries (sustained when a clenched fist hits a person’s teeth).