Certified Wound Ostomy Nurse (CWON) Practice Test

What does undermining refer to in wound care?

1. Tissue expansion beyond the wound margin

2. Tissue destruction underlying intact skin along wound margins

3. Formation of new tissue over the wound

4. Presence of slough in the wound bed

The correct answer is: Tissue destruction underlying intact skin along wound margins

Undermining in wound care specifically refers to the area of tissue destruction that occurs beneath the intact skin at the edges of a wound. This phenomenon occurs when the skin is lifted or pushed back from the wound, which can create a pocket or ledge of tissue that is not visible on the surface but represents a significant area of concern beneath the skin. Recognizing undermining is crucial for wound assessment and management because it can impact the healing process. The presence of undermining indicates that the wound may be more extensive than it appears, potentially requiring more aggressive and strategic interventions to promote healing. The other options do not accurately describe undermining. Tissue expansion beyond the wound margin refers to a different phenomenon related to wound healing and expansion. Formation of new tissue over the wound is part of the healing process and indicates granulation tissue formation, rather than describing the structural integrity of the wound margins. The presence of slough, which is necrotic tissue that is often yellow or tan, pertains to wound bed composition rather than the condition along the wound edges. Understanding these distinctions can aid in effective assessment and treatment planning for optimal wound healing.