Review Podiatry Assessment – Outpatient

Review Podiatry Assessment – Outpatient Purpose of Review: Wound review for chronic plantar ulcer on the left foot, referred by the local community health centre for ongoing management and to assess healing progress following initial debridement. Changes Since Last Assessment: Patient reports reduced pain in the affected foot since the last assessment two weeks ago. The wound itself appears to be shrinking in size, and there are no new signs of infection reported. The patient has been compliant with offloading instructions and daily dressing changes as advised. No changes in footwear use. Clinical Review Findings: Wound on the plantar aspect of the left foot, distal to the metatarsal heads. Current wound dimensions are 1.5 cm x 1.0 cm x 0.2 cm (previously 2.0 cm x 1.5 cm x 0.3 cm). Wound bed is 70% granular with 30% slough, no signs of purulent discharge or foul odour. Peri-wound skin is intact, warm, and non-erythematous. Pedal pulses are palpable (dorsalis pedis and posterior tibial, 2+/4 bilateral). Capillary refill time is <3 seconds. No new callus or fissures observed. Nail health is stable. Gait remains antalgic but improved compared to previous visit. Interventions Provided: Gentle sharp debridement of remaining slough and hyperkeratotic wound edges. Application of a hydrocolloid dressing with secondary dressing for moisture balance and protection. Re-enforced pressure offloading education and technique, ensuring patient understands the importance of consistent adherence. Discussed optimal footwear choices for continued offloading and protection. Client Progress Toward Goals: Excellent progress toward the goal of wound healing, evidenced by a significant reduction in wound size and improved wound bed appearance. Pain reduction also indicates positive progress. Patient demonstrates good understanding and adherence to self-care instructions. Updated Plan / Recommendations: Rebook for follow-up review in 1 week (8 November 2024) to continue wound assessment and dressing changes. Continue hydrocolloid dressings and pressure offloading. Consider referral to an orthotist for custom accommodative inserts if current offloading measures are insufficient in the long term. Provide updated patient education on signs of infection to monitor at home.