Wound Care Plan

Diabetic Ulcer – Heel (with Charcot foot)

Last Updated

15 April 2026

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Quick Overview

Reference ID Number: WL-WCP-19

Scope of Practice (ScOP) Designation

Registered Nurse (RN),Podiatrist,Enrolled Nurse (EN),Medical Officer

Treatment Goals

Management of long-standing diabetic ulcers requires appropriate offloading via orthotics, monitoring of foot anatomy and plantar pressures through podiatry and orthopaedics, and optimisation of limb perfusion through vascular assessment. Multidisciplinary care, alongside wound management, aims to improve quality of life and maximise patient mobility.

Aim of Dressing

Employ chemical agents for slough removal and use a soft non-adherent dressing compatible with offloading in a customised CAM boot.

Frequency of Dressing Change

2 Days(s) Min - 3 Days (Max)

Consult(s) / Diagnostic Test Required

Reviews by: Vascular surgeons, podiatry, orthotics, physiotherapy, artieral duplex's, toe pressures

References

Shopping List

Dressing Pack (Small),Urgo Clean Ag (10cm x 10cm),Normal Saline,Biatain Foam (Non-adhesive) (10cm x 10cm),Hypafix (5cm x 10m)

Page Table of Contents

Product Selection Disclaimer:

The wound care products being currently used are a suggestion ONLY. They do not take into account your patient's individual needs which you must assess. No funding from medical companies has been provided and wound care products are chosen on their merit and what is available on the NSW Health State Wound Care Contract. Where an exact brand name product is not available we suggest you review the alternative tab or use another wound care product from its category eg. Hydrofibre

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Care Plans

Foam Dressings

Where a patient is unable to manage an ACTIV.A.C device, a foam dressing may be used to prevent clumping and avoid focal pressure points on the foot.

Swipe

Step 1

Prepare Sterile Field

Prepare a sterile field and arrange all sterile products using aseptic technique.

Products Used

Dressing Pack (Small),Urgo Clean Ag (10cm x 10cm),Biatain Foam (Non-adhesive) (10cm x 10cm),Hypafix (5cm x 10m),Normal Saline

Step 2

Clean wound bed

Debride any hardened devitalised tissue to reduce undermining and support approximation of viable wound edges. This intervention may require a surgeon, podiatrist, or wound care professional.

Products Used

Gauze squares

Step 3

Apply Urgo Clean Ag

Cut the first piece of foam to approximate the wound bed shape and place within the defect, then apply a second foam layer to level the wound with the heel base.

Products Used

Urgo Clean Ag (10cm x 10cm)

Step 4

Cover with Biatain

Apply the Biatain Non-adhesive

Products Used

Biatain Foam (Non-adhesive) (10cm x 10cm)

Step 5

Secure

Secure dressing with Hypafix

Products Used

Hypafix (5cm x 10m)

Vac dressings

Where the patient is able to mobilise with an Acti V.A.C, wound healing time may be significantly improved; however, there is an associated risk of device leakage and tripping hazards.

Swipe

Step 1

Prepare Sterile Field

Prepare your sterile field with your sterile products

Products Used

Dressing Pack (Large),Normal Saline,Vac Bridge Dressing,Sterile Scissors,Friars Balsam (25ml)

Step 2

Clean wound bed

Debride hardened devitalised tissue to reduce undermining and promote approximation of fresh wound edges. This intervention may require a surgeon, podiatrist, or wound care professional.

Products Used

Gauze squares