Wound Care Nursing Assessment Form
Patient Name
Medical Record Number
Date of Assessment
Location of Wound
Type of Wound
Surgical
Pressure Injury
Diabetic Ulcer
Trauma
Other
Duration
Wound Measurement (Length x Width x Depth in cm)
Wound Bed Appearance
Granulation
Slough
Eschar
Others
Exudate Amount
None
Scant
Moderate
Heavy
Exudate Type
Serous
Sanguineous
Purulent
Serosanguineous
Odor
None
Present
Wound Edges
Surrounding Skin Condition
Pain Assessment (0-10)
Current Dressing
Other Observations / Comments
Nurse Name
Signature