Wound Care Plan

Gout – (Tophaceous) – Great toe

Last Updated

16 April 2026

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Quick Overview

Reference ID Number: WL-WCP-71

Scope of Practice (ScOP) Designation

Medical Officer,Registered Nurse (RN)

Treatment Goals

Removal of tophaceous deposits to facilitate healing by secondary intention.

Aim of Dressing

To flush and debride the wound of tophaceous material to support healing by secondary intention, recognising that the wound edges are non-viable.

Frequency of Dressing Change

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

Consult(s) / Diagnostic Test Required

Surgical washout by orthopedic team

References

Shopping List

Dressing Pack (Small),Normal Saline,Iodine (100ml) (AKA Betadine),Wound Probe,Aquacel Ag Ribbon (2cm x 45cm),Zetuvit Plus (10cm x 10cm),Cotton Role – Multigate,Crepe Bandage (15cm x 1.5m)

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

Bedside washout of gout tophi

To wash out the cavity left after the primary wash out in theatre and pack

Swipe

Step 1

Wash and clean the foot

Wash and clean the foot well

Products Used

Step 2

Clean the wound

Establish a sterile field and transfer sterile dressings onto it using ANTT principles.

Products Used

Dressing Pack (Small),Normal Saline

Step 3

Clean the wound

Gently clean the wound; irrigation of the cavity using a syringe may be required.

Products Used

Step 4

Slush the wound cavity out

Irrigate the wound cavity using a syringe with undiluted iodine. Assess for any communication with the skin; if none is identified, gently milk out the remaining iodine.

Products Used

Iodine (100ml) (AKA Betadine),18g Cannula

Step 5

Pack the wound cavity

Probe the wound to assess depth and obtain measurements. Cut the Aquacel Ag ribbon in half widthways to facilitate insertion. Using the probe, gently guide the ribbon into the wound bed, ensuring it reaches the base of the wound to prevent fluid collection and microbial accumulation.

Products Used

Aquacel Ag Ribbon (2cm x 45cm),Wound Probe