Wounds of uncertain cause or non-healing ulcers

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Useful Management Information

The Wounds Australia  Standards for Wound Prevention and Management may provide additional management guidance.
Consider using the  Tissue, Infection/Inflammation, Moisture, Epithelial/Edge (T.I.M.E.)  model.
Consider referring to the  eTG section on Cellulitis  particularly for appropriate antibiotic management.
Consider using the Bates-Jenson Wound Assessment Tool.
Consider referral to a dietitian to optimise nutritional status for wound healing.
Consider referral to a podiatrist or high risk foot clinic for assessment and wound care of foot/ankle wounds.

Minimum Referral Criteria

Category 1	Wound or ulcer of uncertain aetiology that is progressing in size despite adequate dressings and leg elevation Uncomplicated foot ulcer in diabetic patient of recent onset Suspected malignant ulcer Acute onset varicose or arterial ulcer Acute onset ulcer in patients receiving high dose steroids or immunosuppressive agents
Category 2	Subacute or chronic ulcer of uncertain aetiology  that is not responding to appropriate treatment
Category 3	No category 3 criteria
If your patient doesn't meet the minimum referral criteria If the patient does not meet the criteria for referral but the referring practitioner believes the patient requires specialist review, a clinical override may be requested: Please explain why (e.g. warning signs or symptoms, clinical modifiers, uncertain about diagnosis, etc.) Please note that your referral may not be accepted or may be redirected to another service.

Standard Referral Information

Reason for request

To establish a diagnosis
For treatment or intervention
For advice and management
For specialist to take over management
Reassurance for GP/second opinion
For a specified test/investigation the GP can't order, or the patient can't afford or access
Reassurance for the patient/family
For other reason (e.g. rapidly accelerating disease progression)
Clinical judgement indicates a referral for specialist review is necessary

Relevant clinical information about the condition

Presenting symptoms (evolution and duration)
Physical findings
Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
All conservative options that have been pursued unsuccessfully prior to referral
Body mass index (BMI)
Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes, BMI), noting these must be stable and controlled prior to referral
Any special care requirements where relevant (e.g tracheostomy in place, oxygen required)
Current medications and dosages
Drug allergies
Alcohol, tobacco and other drugs use

Patient's Demographic Details

Full name (including aliases)
Date and country of birth
Residential and postal address including whether patient resides at an aged care facility
Telephone contact number/s – home, mobile and alternative
Medicare number (where eligible)
Name of the parent or caregiver (if appropriate)
Name of delegate and contact details (Department of Corrective Services)
Preferred language and interpreter requirements
Identifies as Aboriginal and/or Torres Strait Islander
Any special needs, access requirements and/or disability relevant to the referral

Referring Practitioner Details

Full name
Full address
Contact details – telephone, fax, email
Provider number
Date of referral
Signature
Nominated general practitioner’s details (if known), if the nominated general practitioner is different from the referring practitioner

Other relevant information

Willingness to have surgery (where surgery is a likely intervention)
Choice to be treated as a public or private patient
Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)

Essential Referral Information

Relevant medical history, comorbidities (particularly diabetes, neuropathy, peripheral arterial disease, cognitive impairment, drug abuse, mental health problems) and medications
Wound history
- duration
- description and size
- wound initiating event
- presence of peripheral pulses if limb wound
Investigations (if performed)
- any biopsies of the wound
- for leg ulcers, include:
- arterial studies / Ankle Brachial Pressure Index
- venous incompetence studies (note NOT venous ultrasound for acute DVT)
Treatment history - including
- wound care provided to date (including antibiotics, topical ointments, etc)
- service provider (i.e. GP, practice nurse or domiciliary nursing service)
FBC
U&E
Creatinine
LFT

If a specific test result is unable to be obtained due to access, financial, religious, cultural or consent reasons a Clinical Override may be requested. This reason must be clearly articulated in the body of the referral.

Additional Referral Information

Residential status (lives alone, support networks, etc)
Access to wound care services, domiciliary nursing
Smoking status
Nutritional status / dietary intake / serum albumin
HbA1c / blood sugar control (if patient has diabetes)

Send Referrals To

Smart Referrals

Coming Soon

Internal Referrals

Internal Medicine (E-Blueslips)

Fax

5687 4497

Post

Booking and Referral Centre
Gold Coast University Hospital
1 Hospital Boulevard
Southport QLD 4215

Enquiries

1300 559 083

Service Availability

Facilities

Gold Coast University Hospital

Robina Hospital

If you would like to send a named referral, please address it to the specialist listed above, who will allocate a suitably qualified specialist to see the patient. Alternatively, you can view a full list of our specialists.