Pathophysiologic assessment in chronic foot ulcers

The conceptual diagram illustrates the interaction between the main factors that contribute to tissue loss. This scheme is appropriate for any patient with a chronic wound/tissue loss. The clinician should ask, "Which factor or combination of factors contributes the most to the pathophysiology of the wound? Ischemia? Infection? Wound extent?" Early assessment helps determine initial wound management priorities, but frequent reassessment is important since the wound environment is dynamic, and the balance toward one or another factor can change.