Wound Management

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  Emergency

  If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or follow local emergency care protocols or seek emergent medical advice if in a remote region.

  Wounds of traumatic aetiology

  • Systemic inflammatory response symptoms (SIRS) or clinically unwell
  • Wounds with complex foreign body involvement and significant damage to associated surrounding structures including blood vessels, nerves, muscles, joints and tendons.
  • Wounds with associated compound fractures
  • Persistent significant bleeding not controlled with usual measures
  • Worsening pain and/or pain not in keeping with mechanism of injury
  • Initial acute burns should be managed as per ANZBA guidelines
  • Refer to Vascular High Risk Foot CPC or Diabetic High Risk Foot CPC

  Arterial/ischaemic ulcer

  • Systemic inflammatory response symptoms (SIRS) or clinically unwell
  • Worsening pain and/or pain not in keeping with progression of the wound/ulcer
  • Sepsis or acutely unwell due to infection3
  • Acute or critical limb ischaemia with necrosis
  • Rapidly deteriorating ulceration or necrosis.3
  • Ulcers or wounds in a limb with markedly compromised circulation

  Wounds on the High-Risk Foot

  • Systemic inflammatory response symptoms (SIRS) or clinically unwell
  • Worsening pain and/or pain not in keeping with progression of the wound/ulcer
  • Progressive cellulitis despite initial treatment
  • Acute or critical limb ischaemia with necrosis
  • Acute Charcot arthropathy if access to podiatry is not accessible within 48 hours

  Stoma related wounds

  • Systemic inflammatory response symptoms (SIRS) or clinically unwell
  • Worsening pain and/or pain not in keeping with progression of the wound
  • Progressive cellulitis despite initial treatment
  • Suspected incarcerated hernia or underlying abscess
  • Suspected bowel obstruction resulting in non-functioning stoma
  • Persistent significant bleeding not controlled with usual measures
  • Stomal change in colour from red / pink to blue or black
  • Stomal prolapse causing circulatory compromise
  • Bleeding peristomal varices
  • Ongoing high output stoma and signs of dehydration

  NB: If the problem is with the stomal appliance the patient can self-refer to stomal therapy nurse. Patients not in contact with regular stomal therapy nurse/service can be referred by GP.

  Pressure injury

  • Systemic inflammatory response symptoms (SIRS) or clinically unwell
  • Worsening pain and/or pain not in keeping with progression of the wound/ulcer
  • Pressure injury if causing systemic infection
  • Patients with spinal injuries should be referred to Spinal Outreach Team (SPOT)

  Post-operative wound/dehiscence

  • Systemic inflammatory response symptoms (SIRS) or clinically unwell
  • Worsening pain and/or pain not in keeping with progression of the wound/ulcer
  • Prosthesis / metal work is on view
  • Purulent discharge with associated fevers
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  CPC in scope Not an exhaustive list

  Please note this is not an exhaustive list of all conditions for outpatient services and does not exclude consideration for referral unless specifically stipulated in the CPC out of scope section.

  • Arterial/ischaemic ulcer ADULT
  • Post-operative wound/dehiscence ADULT
  • Pressure injury ADULT
  • Stoma related wounds ADULT
  • Wound of uncertain cause or Non-healing ulcer ADULT
  • Wounds of traumatic aetiology ADULT
  • Wounds on the High-Risk Foot ADULT
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  CPC out of scope

  The following are not routinely provided in a public Wound Management service.

  • Initial acute burns should be managed as per ANZBA guidelines
  • For High Risk Foot service please see Vascular High Risk Foot CPC or Diabetic High Risk Foot CPC unless service is not readily available.
  • Patients with spinal injuries should be referred to Spinal Outreach Team (SPOT)