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A 36-year-old member asked:

How do undermining and tunneling differ in regards to stage 4 pressure ulcers?

3 doctor answers3 doctors weighed in
Dr. Krishna Narayanan
Specializes in Plastic Surgery
Undermining: Undermining occurs beneath the skin surface in continuation with the ulcer. Tunneling can occur in a deeper plane f the wound base.
Created for people with ongoing healthcare needs but benefits everyone.
Dr. Michael Miller
Wound care 37 years experience
Different etiologies: Our skin is made to take direct pressure, the deep tissues are not. When pressure is applied, it spreads out and depending on the direction "kills" the tissues under the skin causing undermining. A tunnel occurs when there is lateral force to the deep tissues disrupting the tissue planes in the direction of that force creating a "tunnel". Treatment is the same...Stay off it !
Created for people with ongoing healthcare needs but benefits everyone.
Dr. David Hardin
Wound care 37 years experience
Semantics: The process is the same for both, pressure damageto softer tissue underlying the comparatively tough skin. Undermining leaves a shelf of skin over a cavity while tunneling is a relatively straight line as its name would suggest covering possibly a great distance under the skin.
Created for people with ongoing healthcare needs but benefits everyone.

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CA
A 39-year-old member asked:

What is the difference between undermining and tunneling in regards to stage 4 pressure ulcers?

4 doctor answers11 doctors weighed in
Dr. Oliver Aalami
Vascular Surgery 24 years experience
Length of tunnel: Undermining is when a wound diameter is wider at its base (deep in the wound) than at the wound's skin edge. For example, the hole in the skin may be 5mm, but the base of the wound cavity is 10mm. Tunneling is when the wound tracks under the skin to another opening in the skin or to a deeper cavity. Tunnels are sometimes referred to as a "sinus" or "tract".
Created for people with ongoing healthcare needs but benefits everyone.

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Last updated Sep 29, 2016

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