As a CWS for 8 years, I have never heard the phrase "resolved with a defect". If the wound is not completely re-epithelialized, then it is not "resolved", defect or not. I would look into specifics concerning the inability for this wound to achieve complete closure. Are the wound edges epibolized, is the patient malnourished?, have you tried an e-stem unit, such as Micro-Z?, nutritional supplements, have you ruled out wound bed bioburden? I assure you that for MDS purposes, "resolved with a defect" is NOT acceptable terminology.