Table 12. Questions to Ask When Dealing with Nonresponse
or Recurrence
Is there a failure of wound healing?
• Is the patient adhering to the wound care regimen?
• Has the wound been adequately debrided?
• Has the wound been appropriately dressed?
• Has the wound been adequately offloaded?
• Is there unidentified or untreated ischemia?
• Is the lesion malignant?
• Is there undiagnosed or improperly treated infection?
Is there a failure of infection to respond?
• Is there unidentified or untreated limb ischemia?
• Is there unidentified necrotic soft tissue or bone?
• Is there an undrained abscess?
• Has the wound been adequately debrided?
• Is there osteomyelitis that has not yet responded?
• Is there an untreated or an unidentified pathogen?
• Is there an antibiotic delivery problem?
• Is there an antibiotic non-adherence issue?
• Have all metabolic aberrations been corrected?
Figure 1. Schematic Diagram of Cross-Section of the Foot
B
2
1
3
4
5
C
A
D
Numbers 1-5 indicate metatarsal bones. A= central plantar space; B= deep interosseous space;
C= lateral plantar space; D= medial plantar space.
13
