Chronic Wounds

What we do

Our Chronic Wound service provides specialist care to people who have wounds that are not healing as expected, such as wounds:

• Older than 28 days
• Not responding to current treatment
• Of unclear cause

We are a multidisciplinary service, providing support to patients with chronic wounds:

• Assessing and diagnosing wound causes, except for non-diabetic foot wounds
• Recommending a wound care plan appropriate for wound cause, condition and in agreement with patients’ goals, including treatment such as ultrasound-guided therapy
• Recommending interventions to assist wound healing such as compression therapy, debridement and offloading
• Educating patients about wound healing, skin care and other factors impacting on wound healing such as nutrition and social stressors
• Guiding the next steps for patients whose wounds will not heal
• Referring patients to other community health providers, such as lymphoedema specialists

Who can use our service

This service is suitable for people:

• Who are aged 18 years or older
• With persistent broken skin present for longer than four weeks
• Who are able to attend clinic independently or with minimal assistance to get to clinic
• Who live in local city council areas of Melbourne, Moreland and Hume (but we may accept referrals from other areas after discussion)
• With a problematic/complicated wound requiring specialist advice

This service is not suitable for: 

• Uncomplicated acute wounds (present <4 weeks) for example, recent surgical wound already being managed by a surgical unit
• Patients that are medically unstable or with severe infection or cellulitis that requires GP or Emergency Department intervention
• Diabetic foot wounds - refer directly to the Diabetic Foot Unit

What to expect

There is no charge for this service. Dressing materials that are used outside of the clinic are not supplied. We can provide you advice about where to purchase items if necessary.

The initial assessment usually takes between 60 - 90 minutes. At this time we aim to determine the likely cause of the wound or reason for delayed healing. 

Unfortunately, some wounds do not heal or heal extremely slowly. We will devise a management plan together with you, based on your priorities and the ability of the wound to heal.

Most people return to the clinic weekly or fortnightly at the beginning of their treatment. This is to help us review the new treatment and check whether it is working the way we had expected. Once a treatment is stable, your follow-up appointments will be less frequent.

Communication will be provided to your family doctor after your initial visit and again anytime there are changes to your wound management plan. We may also send a copy of letters to other community nursing or allied health teams.

If there is a waiting list, you'll be advised what to do in your letter. Keep a copy of your referral, so you can easily ask your GP to renew your referral if you need to.

Who's involved in patient care

The following health professionals may be involved in patient care:

• Clinical nurse consultants - focus on holistic assessment of patient and wounds, provide wound care plan, and recommendations based on advanced wound knowledge
• Podiatrists - focus on wounds below ankles that are not diabetic wounds. Podiatrists also have in-depth knowledge on high risk foot, appropriate footwear assessment, and offloading techniques for feet
• Doctors - focus on identifying medical issues or medication issues which can impact on patients’ wounds, providing recommendations or changes to those issue with goal to aid wound healing
• Social workers - provide support and interventions to the patient and family regarding the losses and changes in life associated with non-healing wounds
• Dietitians - who provide comprehensive nutritional assessment for patient with wounds, and recommend nutritional intervention to aid wound healing by improving nutritional status
• Vascular surgeons - provide timely advice and treatment on underlying venous or arterial issues which are critical to healing of wounds 
• Interpreters - accredited interpreters can assist in communication between clinic specialists and patients