The last day of operation for Hertfordshire and West Essex ICB was 31 March 2026. The information on this website has not been updated since 31 March 2026. The legacy policies, prescribing recommendations and pathways can be accessed on this website. Find out more

Foot / Lower Leg Wounds, including Ulcers

First Line Foot Ulcer Management:
The pathway emphasizes a systematic approach to wound care, incorporating evidence-based practices to promote healing and prevent complications. It includes protocols for timely referrals to specialized teams, such as podiatry and tissue viability services, and outlines criteria for prescribing appropriate dressings and treatments.

 

If signs of ischaemia/ gangrene- patient requires same day/ urgent referral to vascular team.

If signs of systemic spreading infection- arrange urgent assessment at hospital for IV antibiotics +/- review at MDT

If signs of local infection- start oral antibiotic as per guideline and refer to podiatry within 24 hours

If evidence of pressure ulcer- refer to community district nurses. If further deteriorating, patient would require review by podiatry /TVN and / or vascular team

If patient is already known to podiatry service- ensure prompt referral to podiatry team and follow up.

 

Please see pathway attached for further details.


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