Introduction

Early and frequent assessment of patients with a high-risk foot wound is essential. Appropriate assessment and management minimises the risk of wound deterioration, further wounds or amputation.

For structured advice on examination, see Foot examination. Assess for peripheral neuropathy and peripheral arterial disease. Review current footwear for suitability, fit and wear, and consider whether pressure redistribution can be accommodated within the shoe.

Patients with peripheral neuropathy often have loss of sensation, so are unable to detect damage or discomfort to their feet and are less likely to take appropriate action to prevent tissue damage. Patients with peripheral neuropathy must be educated about foot care (see Advice for patients about foot care) and appropriate footwear (see Advice for patients about footwear), and be reviewed by a podiatrist.

If the patient has diabetes, check for hyperglycaemia or poor vision as these may affect the management plan.