The Big Picture
Skin protects the body from microbes that cause infection and disease. When the skin or a mucous membrane breaks, the opening is called a wound. This opening gives microbes a way to enter the body.
Good skin care helps protect the skin from injury. Support workers also need to notice skin problems, report them immediately, and understand the main ways wounds are described.
Wounds differ in how they happen, whether the skin breaks, their risk for infection, and how deeply the tissues are damaged.
Look for Nova Scotia CCA Notes throughout this page for current provincial guidance.
Quick tip: Tap, click, or press Enter on any term with a dotted underline and an ⓘ icon to see its plain-English definition.
Start Here If You’re Overwhelmed
Focus on these core ideas:
- A wound is a break in the skin or mucous membrane.
- Infants, older persons, and clients with disabilities face greater risk for skin breakdown.
- Report signs of skin problems immediately to the nurse or supervisor, depending on the workplace.
- Wounds include abrasions, contusions, incisions, lacerations, penetrating wounds, and puncture wounds.
- Wounds are also classified as open or closed, intentional or unintentional, and by infection risk.
- Wound depth includes partial-thickness and full-thickness wounds.
Jump to:
Course Notes: Key Ideas You Need to Know
Why Healthy Skin Matters
Skin is the body’s first line of defence. It helps protect the body from microbes that cause infection and disease.
Good skin care is an important support worker responsibility. Frequent and thorough skin care helps prevent skin injury.
Support workers need to look for signs of skin problems in every client.
Report: Signs of skin problems should be reported immediately to the nurse or supervisor, depending on the workplace.
Who Is at Greater Risk for Skin Breakdown?
Infants, older persons, and clients with disabilities face the greatest risk for skin breakdown. Limited mobility and certain health conditions make their skin more vulnerable to injury.
Infant skin and older adult skin differ from each other.
Clients with diabetes or circulation problems tend to heal more slowly. They also face a greater risk for wound and skin infections.
Common Causes of Skin Breakdown
Common causes include:
- age-related changes in the skin
- skin dryness
- fragile and weak capillaries
- general thinning of the skin
- loss of the fatty layer under the skin
- decreased sensation to touch, heat, and cold
- decreased mobility
- sitting in a chair or lying in bed most or all of the day
- persistent diseases, such as diabetes and high blood pressure
- diseases that decrease circulation
- poor nutrition
- poor hydration
- incontinence
- moisture in skin folds, under the breasts, between the toes, and around the perineal area
- pressure on bony parts of the body
- poor fingernail or toenail care
- friction and shearing
Friction happens when skin rubs against another surface, such as clothing, bedding, or another skin fold.
Shearing happens when the skin stays against a surface while deeper tissues move downward. This movement tears skin tissue and places pressure on the skin.
What Is a Wound?
A wound is a break in the skin or mucous membrane. The break creates an opening where microbes enter.
Wounds develop for different reasons.
A surgical incision creates a wound. Wounds also result from trauma, immobility, or poor blood circulation.
For this topic, trauma means an accident or violent act that injures the skin, mucous membranes, bones, or internal organs. Examples include falls, vehicle accidents, gunshots, and stabbings.
When a wound occurs, infection becomes a major concern. Wound care helps prevent infection and further injury to the wound and nearby tissues.
The Support Worker’s Role in Wound Care
A support worker’s role in wound care depends on:
- provincial or territorial laws
- the worker’s job description
- the client’s condition
Support workers need to understand wound types, wound healing, and ways to promote healing.
Safety: Follow Standard Practices and wear gloves when dealing with any open wound.
Wound-care protocols differ among agencies, municipalities, provinces, and territories. Support workers need to follow the protocols used by their agency.
Physicians sometimes order heat or cold applications as part of wound care. These applications support healing and comfort and reduce tissue swelling.
Nova Scotia CCA Note
Sorrentino’s Canadian Textbook for the Support Worker, 5th Edition gives the broad rule that a support worker’s wound-care role depends on provincial requirements, the job description, and the client’s condition. Nova Scotia’s current Continuing Care Assistant Occupational Standards of Practice give a more specific limit for CCAs.
In Nova Scotia, a CCA performs an observational point of care assessment that includes observing a person’s skin integrity and recognizing changes that need to be escalated to a supervisor. This is not a nursing assessment. It does not permit the CCA to perform the comprehensive evaluation used to make clinical decisions or plan care. (novascotiacca.ca)
Why this matters in Nova Scotia: For CCA study and practice, separate observing skin changes and reporting them from the broader assessment and clinical decision-making role of regulated health professionals.
Official source: Continuing Care Assistant Occupational Standards of Practice
Last checked: September 14, 2026
Common Types of Wounds
Abrasion
An abrasion is a partial-thickness wound caused when skin gets scraped or rubbed away.
Contusion
A contusion is a closed wound caused by a blow to the body. Another name for a contusion is a bruise.
Incision
An incision is an open wound with clean, straight edges. A sharp instrument usually creates it intentionally.
Laceration
A laceration is an open wound with torn tissue and jagged edges.
Penetrating Wound
A penetrating wound is an open wound caused by an object entering the body.
The injury ranges from a shallow puncture near the skin surface to deep penetration involving major body systems. A knife or bullet is an example of an object associated with this type of wound.
Puncture Wound
A puncture wound is a closed wound usually caused by a sharp, pointed object. Examples include a tack, pin, nail, or animal teeth.
A puncture wound usually does not bleed a lot. It sometimes appears to close by itself.
Puncture wounds are prone to infection and need quick, appropriate treatment.
Difference: A penetrating wound is described as open, while a puncture wound is described as closed.
Intentional and Unintentional Wounds
Intentional Wound
An intentional wound is created for treatment.
Examples include:
- surgical incisions
- sterile vein punctures for starting intravenous therapy
- sterile vein punctures for collecting blood specimens
Unintentional Wound
An unintentional wound results from trauma.
Examples include wounds caused by:
- falls
- vehicle accidents
- gunshots
- stabbings
Open and Closed Wounds
Open Wound
An open wound involves a break in the skin or mucous membrane.
Intentional wounds and most unintentional wounds are open wounds.
Closed Wound
A closed wound involves tissue injury without a break in the skin.
Examples include:
- bruises
- twists
- sprains
Wounds and Infection Risk
Wounds are also described according to contamination and infection.
Clean Wound
A clean wound is not infected. Microbes have not entered the wound.
Closed wounds and intentional wounds created under surgically aseptic conditions are usually clean.
Clean wounds have a lower infection risk when the urinary, respiratory, and digestive systems have not been entered.
Clean-Contaminated Wound
A clean-contaminated wound results from surgical entry into the urinary, reproductive, or digestive system using sterile technique.
These systems are not sterile and contain normal flora. The infection risk is greater than with a clean wound.
Contaminated Wound
A contaminated wound has been exposed to pathogens and has a high risk for infection.
An unintentional wound, such as a stabbing wound created outside sterile conditions, is one example.
Contamination also results from:
- a break in surgical asepsis
- spillage of intestinal contents
The tissues might show signs of inflammation.
Infected Wound
An infected wound, also called a dirty wound, contains large numbers of bacteria and shows signs of infection.
Examples include:
- old wounds
- surgical incisions into infected areas
- traumatic injuries that rupture the bowel
Chronic Wound
A chronic wound does not heal easily within a timely period.
Examples include:
- a pressure injury
- a circulatory ulcer
Continual exposure to friction, pressure, or moisture puts a wound at risk of becoming chronic.
Partial-Thickness and Full-Thickness Wounds
Wound depth is another way to describe a wound.
Partial-Thickness Wound
A partial-thickness wound involves breaks in the epidermis and dermis of the skin.
Full-Thickness Wound
A full-thickness wound extends through the epidermis, dermis, and subcutaneous tissue.
Muscle and bone are possible areas of involvement.
Exam Clue Words
- Report: Report signs of skin problems immediately to the nurse or supervisor, depending on the workplace.
- Immediately: Do not treat skin problems as something to report later.
- Any open wound: Follow Standard Practices and wear gloves when dealing with any open wound.
- Depends on: The support worker’s wound-care role depends on provincial or territorial laws, the job description, and the client’s condition.
Fast Review
Focus on these facts during a quick review:
- Skin is the body’s first line of defence against microbes that cause infection and disease.
- A wound is a break in the skin or mucous membrane that gives microbes a portal of entry.
- Report signs of skin problems immediately to the nurse or supervisor, depending on the workplace.
- Common skin-breakdown factors include limited mobility, pressure, moisture, poor nutrition, poor hydration, friction, and shearing.
- An abrasion involves scraped or rubbed-away skin, while a contusion is a closed wound caused by a blow.
- An incision has clean, straight edges, while a laceration has torn tissue and jagged edges.
- A penetrating wound is open, while a puncture wound is described as closed and is prone to infection.
- An intentional wound is created for treatment. An unintentional wound results from trauma.
- An open wound breaks the skin or mucous membrane. A closed wound injures tissues without breaking the skin.
- Clean, clean-contaminated, contaminated, infected, and chronic wounds describe different wound conditions and infection risks.
- A partial-thickness wound involves the epidermis and dermis. A full-thickness wound also extends through subcutaneous tissue.
- Follow Standard Practices, wear gloves for any open wound, and follow the wound-care protocols used by the agency.
Final Pep Talk
There are many wound names and classifications here, so focus on the differences that separate one type from another. Review them in small groups, then come back to the Fast Review until the terms feel familiar.