When you arrive at the clinic the following patient information is gathered:

• Patient and wound history
• Medication history
• Co-morbidities (existing conditions) and factors influencing healing
• Patient centred concerns (pain, socio-economics, habits)
• Clinical data (blood pressure, pulses, blood glucose, BMI, blood flow)

It is important to evaluate the blood flow to the affected limb before starting any wound care treatment.  This can be done manually be feeling the different pulses or by using a mini doppler sonar device.  Without blood flow healing is not possible unless it can be improved by using advanced technology such as the VACUMED vascular flow regeneration device or using compression bandages in venous leg ulcers or by vascular surgery done by a vascular surgeon.

Leg ulcers may have several causes and it is important to make the correct diagnosis to differentiate the management there off.  Types of ulcers treated at the Centre include:

• Arterial ulcers

• Venous ulcers

• Mixed arterial/venous ulcers

• Hypertensive ischemic ulcers

• Malignant ulcers

When a wound assessment is done it is also important to identify the differentiate between the clinical signs and symptoms of localized infection, systemic infection, and persistent inflammation.  This is done at Centre by using international guidelines in determining whether antibiotics is needed.  If needed a wound swab is taken to determine which bacteria is involved and send to the lab for culture.   

Types of infection and inflammation include:

• Localised or superficial infection

• The Development of Biofilm

• Systemic or deep tissue infection

• Chronic inflammation

Pressure is one of the leading causes for amputation in the vascular compromised diabetic foot.  This is also why the correct footwear is essential in preventing damage and also in protecting the foot.  In patients that are immobile the risk for developing pressure injuries also increases due to sustained pressure over a bony prominent area.       Early detection of pressure areas are key in preventing necrosis, amputation and ultimately the loss of life.  Lack of pressure can also create wounds in the case of venous leg ulcers and patients suffering from lymphoedema. 

In the case of venous hypertension and lymphoedema compression bandaging and compression garments can be limb saving. 

Types of wounds involved with pressure include:

• Diabetic Foot Ulcers

• Pressure Injuries and Pressure ulcers

• Deep Tissue Injury

• Lymph and venous ulceration

After the initial patient assessment, a thorough clinical wound assessment is done according to the International Guidelines T.I.M.E.