Ulcer on ulcer on foot. 25 years back an ulcer erupted due to bad treatment of

A foot ulcer that occurred 25 years ago following poor treatment of an injury does require appropriate clinical assessment, and if the ulcer is currently active or chronic, debridement will likely be necessary to promote healing and prevent complications. Debridement is a key component of diabetic foot ulcer management and involves the removal of dead or necrotic tissue to facilitate wound healing and reduce infection risk NICE NG19 Aditya et al. 2025. Even chronic ulcers that have been present for many years warrant thorough evaluation, including assessment of size, depth, and presence of infection or osteomyelitis NICE NG19 Bolandi et al. 2025. In the context of a long-standing ulcer, especially with a history of poor initial treatment, the wound may have necrotic tissue or other non-viable components that hinder healing, thus requiring surgical or sharp debridement performed by trained healthcare professionals within a multidisciplinary foot care team NICE NG19 Aditya et al. 2025.

Guidelines emphasise that wound debridement should be part of the standard care for diabetic foot ulcers, with techniques tailored to the ulcer’s characteristics and patient preferences, undertaken by appropriately skilled personnel NICE NG19. Debridement helps to prepare the wound bed, encourage granulation tissue formation, and reduce bacterial load, which is crucial given the high risk of infection and osteomyelitis in chronic ulcers Aditya et al. 2025 Bolandi et al. 2025. The presence of chronic ulceration of long duration may also increase the risk of deep infections such as osteomyelitis needing prompt recognition and management, often requiring a combination of debridement, systemic antibiotics, and sometimes surgery NICE NG19 Bolandi et al. 2025.

Considering the ulcer occurred 25 years ago, it is highly recommended to refer the person to a multidisciplinary foot care service for comprehensive assessment, including vascular status, neuropathy, and infection signs, to ensure an individualized treatment plan that includes wound cleansing, offloading, infection control, and debridement as appropriate NICE NG19 Aditya et al. 2025. Persistent ulcers may also benefit from advanced wound dressings and adjunctive therapies, but debridement remains a cornerstone of treatment to optimise healing NICE NG19 Aditya et al. 2025.