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Undermining Wound: Definition, Closure & Treatment

Instructor: Dan Washmuth

Dan has taught college Nutrition, Anatomy, Physiology, and Sports Nutrition courses and has a master's degree in Dietetics & Nutrition.

Undermining wounds are wounds that extend under the skin into the subcutaneous tissue area. Learn about these types of wounds, including how to care for and treat them.

Undermining Wounds

Have you ever seen a Transformers movie or the Transformers cartoon? If you have, then you know that a slogan of Transformers is '''more than meets the eye'' because these robots are experts at disguise and appearing as something they are not. This motto could also apply to undermining wounds, which are definitely not as they appear.

Undermining wounds are wounds that extend in all directions into the subcutaneous tissue under the skin. Subcutaneous tissues, which include muscle and fat, are the tissues under the epidermis and dermis skin layers. Because the undermining extends under the skin, the actual amount of damaged tissue is much bigger than it appears by just looking at the surface of the wound.

Causes of Undermining Wounds

There are several different causes of undermining wounds. One of the most common causes is infection. Once a wound gets infected, the infection can spread into the subcutaneous tissue. As the infection spreads, the tissue that becomes infected can die and become necrotic. Necrotic tissue is any tissue that has died but is still present on the body. This necrotic tissue can quickly spread, resulting in undermining.

Another cause of undermining is pressure being applied to the wound. Forces such as shearing placed on a wound can cause the tissue under the skin to become damaged, resulting in undermining. This occurs frequently in pressure ulcers in people who are bedridden. Pressure ulcers are wounds caused by lack of blood flow to an area of body tissue, which results from a person lying in a bed all day without moving. Shearing forces applied to the wound, such as when a nurse tries to move the patient, can damage the tissue under the skin. This damage can lead to undermining.

Pressure ulcers often have undermining because of lack of blood flow and pressure being applied to the wound. This is a picture of an undermining pressure ulcer on the lower back.
pressure ulcer

Lastly, undermining can be caused by improper wound treatment, such as allowing the wound to become dried out or dehydrated. Wounds heal much more effectively when they are moist. Allowing a wound to dry out might cause impaired wound healing, which can eventually turn into undermining.

Treatment of Undermining Wounds

If a person gets an undermining wound, these steps should be followed in order to care properly for the wound. Following these steps can help the wound to heal and prevent further undermining.

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