Review of patients with wounds on a high-risk foot

Review patients with a current foot wound, or who are at high risk of a foot wound regularly. Frequency of review and wound care varies from daily to weekly based on patient characteristics, wound characteristics and progression, and the environment. For patients with diabetes and an infected foot wound, close monitoring (eg daily) is required initially as patients can deteriorate rapidly.

Factors that influence wound healing in the foot include vascular supply, infection, glycaemic control, nutrition, smoking, deformity, and adherence with pressure redistribution strategies. Regular review should address the factors affecting ulcer and wound healing.

If a wound is not improving, or is deteriorating after 2 weeks, referral and involvement of a specialised multidisciplinary team should be considered (see Interventions for wounds on a high-risk foot). Depending on the aetiology of the wound, consider wider specialist review (including vascular, orthopaedic, endocrinology, rheumatology).