Foot Ulcer

  • Venous ulcers
  • Arterial ulcers
  • Incontinence associated dermatitis
  • Skin tears
  • Intertrigo
  • Neuropathic ulcers
  • Pyoderma gangrenosum, cancers, vasculitides, and other dermatologic conditions

RISK FACTORS

  • Mobility impairment
  • Malnutrition
  • Reduced perfusion
  • Sensory impairement
  • Medical devices

 

Investigation –RBS ,  rule out osteomyelitis Xray  , infection FBE , CRP , ABI, Monophillement ,  no superficial culture value

Comprehensive initial assessment of patient —manage underline issues eg Diabetes , PVD ,neuro

Pressure reduction/redistribution

Nutritional support

Wound assessment and treatment- TIME— hydrogel, hydrocolloid, foam , debridement

Address immobility.

Manage incontinence.

Address pain.

Assess goals of care and advance directives.

Refer – complex or nonhealing wounds, vascular surgery, drainage and/or débridement if advancing cellulitis, plastic surgery for skin graft/flap, dermatology referral if suspected pyoderma gangrenosum, cancer, vasculitis or other dermatologic conditions.