Referral to emergency
If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or seek emergent medical advice if in a remote region.
- suspected deep tissue infection (presence of bullae, necrosis, or subcutaneous emphysema)
- suspected necrotising fasciitis
- facial or orbital cellulitis
- rapidly progressing infection
- rapidly progressing haematoma
- underlying vascular or tendon injury
- hand infections - fingertip, flexor tendon infection, abscess
- deep penetrating injury
- skin threating injury e.g. haematoma, large skin tear
- soft tissue loss greater than 5cm2
- uncontrolled pain after analgesia
- numbness, weakness, or lack of perfusion distal to injury
- lack of systemic or local response to oral antibiotics
- soft tissue injury with systemic features including:
- febrile greater than 38o
- haemodynamic instability
- positive blood cultures
- rising or unchanging C-reactive protein (CRP) and/or white cell count (WCC) despite antibiotics
- hypotension
- tachycardia
For clinical advice, please telephone the relevant metropolitan Local Health Network switchboard and ask to speak to the relevant specialty service.
Women's and Children's Health Network
- Women’s and Children’s Hospital (08) 8161 7000
Category 1 - appointment clinically indicated within 30 days
- acute wound reviews including:
- soft tissue trauma
- haematoma
- abscess of upper limb, face, earlobe, head, and neck
- trauma related delayed healing, lacerations, or wounds
Category 2 — appointment clinically indicated within 90 days
- chronic wounds
- conditions causing recurrent infections
Category 3 — appointment clinically indicated within 365 days
- nil
For information on referral forms and how to import them, please view general referral information.
Essential referral information
Completion required before first appointment to ensure patients are ready for care. Please indicate in the referral if the patient is unable to access mandatory tests or investigations as they incur a cost or are unavailable locally.
- identifies as Aboriginal and/or Torres Strait Islander
- identify within your referral if you feel your patient is from a vulnerable population, under guardianship/out-of-home care arrangements and/or requires a third party to receive correspondence on their behalf
- interpreter requirements
- child/parents demographic information including best contact details
- past medical/surgical history
- current medications and dosages
- allergies and sensitivities
- presenting symptoms
- management history including:
- onset and duration
- severity
- pain
- associated features, e.g. functional impairment and range of motion
- treatments trialled/implemented prior to referral
- photograph, including disposable measurement tool – with patient’s consent, where secure image transfer, identification and storage is possible
Clinical management advice
Women’s and Children’s Hospital (WCH) Plastic and Reconstructive surgery service department holds consultant led outpatient clinics twice weekly.
This is a guideline for outpatient referral only. If you have clinical concerns, please contact the WCH Plastic and Reconstructive surgery service via switchboard on (08) 8161 7000
Clinical resources
- HealthPathways SA – Cellulitis (log in required)
- Royal Children’s Hospital Melbourne - Cellulitis and other Bacterial Skin Infections
- SA Health - Country Referral Unit
- SA Health - Metropolitan Referral Unit