Podiatrist and Chair of Wounds Australia, Kerry May, shares her advice for podiatrists on wound management and she encourages podiatrists to use Wound Australia’s range of free consumer resources.
Kerry has worked across the acute and subacute sectors, and both public and private health care settings, for over 30 years as a clinician and as a health care executive. Her consistent focus has been on the delivery of evidence-based care, aligned with the best possible patient and family experience.
Her professional qualifications include a Bachelor of Podiatry, a Graduate Diploma in Vocational Education and Training, a Master of Gerontology, and an Executive MBA (Distinction).
Throughout Kerry’s career she has gained extensive expertise in governance and advocacy. She was an inaugural member of the Wounds Australia Board as Deputy Chair, was Deputy Chair of the Wounds Australia 2024 Conference Committee, has been an active member of the Victorian Clinical Council Executive and is a current ministerial appointment to the Health Complaints Commissioner Advisory Council.
The mission of Wounds Australia resonates strongly with Kerry: ‘To heal wounds together, to ensure we support clinicians to continue to improve the lives of people living with wounds.’
I’ve been a podiatrist for over 30 years now, and I’ve loved podiatry from day one. I mainly worked in the high-risk foot space. I had the absolute privilege of being one of the co-founders of the high-risk foot service at the Royal Melbourne Hospital that continues to this day. When I was there, we reduced amputations by 50% for our patient group, just with evidence-based, team-based care where the patient is genuinely part of your team.
No one does offloading like podiatrists. As podiatrists, we know that when there are wounds on the feet, offloading is such a huge component – regardless of the primary cause. So don’t underestimate how transferable your skills are when it comes to wound management.
If you’re not comfortable with any aspect of wound management outside of your skillset, then build those links. Bring in the diabetes nurse educator, bring in the clinical psychologist, bring in the rehab physician, and the physio. The more people who can quickly wrap around someone in that high-risk category – the better.
In terms of further escalation of care – if something’s not healing with the right evidence-based treatment in a four to six-week period, refer them on. If someone is in a super high-risk category or they’ve had a complex or chronic wound before, don’t even wait for that. Send them off to the tertiary service who can look at their blood supply, look at their infection management, and look at their offloading in a comprehensive way.
At Wounds Australia, we want to remind podiatrists and other clinicians: “If something’s not healing in a reasonable time frame, escalate it to that high level of care, as appropriate for that person and their wound.”
The challenge is that it can feel confusing for any podiatrist to know what that looks like, and when to refer on. I always say that it’s better to send someone on than to not send them on. No one will ever judge you for doing that.
I’ve run a high-risk foot service, and I never judged anyone for sending someone in. In these cases, I would usually say, “This is not for us, but let’s sort you out and send you back with some good advice.” This provides reassurance to the referring clinician that they’re doing the right things.
Likewise, I think there can be a fear in clinicians, along the lines of, “I’ll look silly if I send something on.” But like anything, don’t manage the stuff that you’re not comfortable managing. It’s always okay to get a second opinion.
It’s also okay to go, “I’m just not sure. I really appreciate your opinion and I’m more than happy to take the care back if you think that’s appropriate.”
I think the other thing I would say to fellow podiatrists is that you often have a really trusted relationship with your patient – given you may see them every six, eight, or ten weeks or every three months.
As podiatrists, we know that the first few weeks of wound care are crucial in influencing longer-term outcomes. Yet our patients may not be clear on how to identify their wound, when to recognise if it is healing or if it needs intervention, and where to go for help.
Your patients know you, they feel comfortable with you, and they trust the advice you give them.
It’s okay to lean into that. And it’s okay to say, “Look, I’m a little bit concerned about this.” Or, “I’d like you to see someone else.” They’ll trust you and go with that.
I’d also encourage podiatrists who are interested in wounds, and are managing wounds, to make sure they’re signed up and have done the training for the Chronic Wound Consumables Scheme. This scheme is amazing. It’s such a game changer for people with a real risk of chronic wounds and hospitalisation.
As a result, your focus becomes fixed on the best wound product as part of a broader treatment plan. Though wound dressings are not the only consideration. Obviously offloading is still so important, looking at blood supply is important, and looking at footwear is important. This scheme means one part of the plan has just become that much easier.
Podiatrists should empower themselves to be able to access that service for their patients. Go and do it, refresh your knowledge if you haven’t already.
If you have a patient who you identify may have a health condition that puts them at risk of serious foot complications, I want to remind you that there are certain steps you can take early on to help educate your patient.
The foot complication might not be happening right now, but it might potentially happen down the track. In these cases, it’s about ensuring you’re clear with those people without scaring them. Tell them what their risks are and when to get help. Then reiterate these messages every time you see them, because people often need to hear a message multiple time to remember it.
Podiatrists play such a key role in reminding people that a wound is not something to be ashamed of. For people living with significant chronic wounds, there can be odour, there can be pain, there can be a real disconnect from their community.
While we’d like people not to have wounds in the first place, we’d like them to be supported to heal quickly, because we know ultimately this is about people’s health and well-being. And that’s mental, as well as physical.
Since the general rule for a ‘normal healing phase’ is around seven to ten days, if something hasn’t healed in this time, we tell health consumers to go and see someone to get it checked. One of the messages we want to get out there is, ‘If it’s a foot wound, see a podiatrist.’
This thinking is partly what led to us creating a range of consumer-facing resources for clinicians to share within their communities – and for consumers to directly access. There are so many useful factsheets available – please take some time to go through these, and to share them with your patients and in your community newsletters.
Access the support that’s available to you – if you’re not already a member of the Australian Podiatry Association, join up to enjoy many member benefits.
And join Wounds Australia because we’d love to have you. Two board members are podiatrists – Dr Peta Tehan and myself. There is certainly a strong message within Wounds Australia around the value of podiatry as part of the wound care community. This message is there in a strong way – so please get involved to support it.
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