10th August 2020

A 54-year-old man presents with a large ulcer on the dorsum of his left foot

A 54-year-old man presents with a large ulcer on the dorsum of his left foot. The sore developed six months ago, and has been managed in the community with regular wound care, but has not shown any sign of healing.  The ulcer is around 60mm in diameter at its widest point and has increased in size since its onset. When removing the dressings there is a foul smell and the tissue is reddened, flat and has a well-demarcated border. Around 25 years ago, the patient suffered burns to that foot after dropping a pan of boiling water. 

Which of the following is the most appropriate next step?

Select the SINGLE most appropriate option from the list below. Select ONE option only.