OASIS Alert
READER QUESTION ~ When Does A Surgical Wound Become A Scar?
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Question: How do we know when a surgical wound goes from "fully granulating" to "healed" and is no longer counted as a surgical wound at all, but just as a surgical scar? Answer: With the new changes to the Wound Ostomy Continence Nurses Society Surgical Wound Guidance, which removes the healing ridge as an assessment criteria, you have to rely on the Centers for Medicare & Medicaid Services' question and answer number 107, says consultant Deborah Chisholm with Redmond, WA-based OASIS Answers. One way to look at this is to ask if the wound has a defined, visible scar or keloid, suggests Phyllis Bonham, CWOCN at the Medical University of South Carolina in Charleston. And even though a healing ridge is no longer part of the definition of a fully granulating/healing wound for OASIS purposes, it is still a helpful landmark, says consultant Lisa Selman-Holman with Denton, TX-based Selman-Holman & Associates. "A fully granulating wound will have an induration of approximately 1 cm on either side of the incision. Once the healing ridge is gone, then the wound becomes a scar," she explains.
"A wound no longer qualifies as a surgical wound when it is completely healed (thus becoming a scar)," CMS instructs. So if you admit a patient with one surgical wound and during the episode it "heals and becomes a scar," at discharge the answer to M0482 (Does this patient have a surgical wound?) would be 0 (No), Chisholm illustrates.
Learn How to Define a Scar
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