Wound Photography and Measurement Record

Standardized form for documenting wound photos, measurements, and consent to support weekly trend review and physician communication.

Submission Notice

• Record Date
• Record Time
• Documented By
  Enter the clinician or staff member completing this record.
• Patient Identifier
  Use the facility-approved identifier only. Avoid collecting unnecessary PII.
• Visit Type

Wound Identification

• Wound Location
• Wound Type
• Laterality
• Stage / Classification
• Approximate Onset Date
  Use the best available estimate if the exact date is unknown.

Wound Measurements

• Length (cm)
• Width (cm)
• Depth (cm)
• Undermining Present?
• Undermining Details
  If present, document clock-face location and depth.
• Tunneling Present?
• Tunneling Details
  If present, document clock-face location and depth.

Wound Appearance and Drainage

• Wound Bed Description
• Drainage Amount
• Drainage Type
• Odor Present?
• Periwound Condition
• Pain Rating

Photography and Consent

• Consent for Wound Photography
  Confirm that consent has been obtained for wound photography and clinical use.
• Consent Method
• Photo Taken?
• Photo Identifier / File Reference
  Use the approved file name, image ID, or chart reference.
• Ruler or Measurement Scale Included in Photo?
• Photo Notes
  Document angle, lighting, or any reason the image may not be suitable for comparison.

Clinical Notes and Follow-Up

• Change Since Last Visit
  Briefly note improvement, decline, or no change.
• Physician Notified?
• Next Follow-Up Date
• Additional Notes
  Include only clinically relevant information.