Lesson 1Assessing exudate, odour, peri-wound skin condition, and wound edge morphologyDetails systematic assessment of exudate, odour, peri-wound skin, and wound edges. Links findings to infection, maceration, ischaemia, and pressure. Guides nurses in consistent terminology and documentation for team communication in diverse clinical environments.
Exudate amount, color, and viscosityDistinguishing serous, sanguineous, purulentOdor timing, intensity, and possible causesPeri-wound maceration, erythema, and eczemaWound edge shape, undermining, and callusStandard terms for describing local findingsLesson 2Characterising tissue types: granulation, necrotic, slough, callus — identification and documentationExplains how to visually and palpably distinguish granulation, slough, necrosis, and callus in diabetic foot wounds. Focuses on accurate description, percentage estimates, and implications for healing and debridement planning in resource-limited settings.
Normal skin, epithelial tissue, and scarGranulation tissue color and qualitySlough appearance, texture, and adherenceDry and wet necrosis, eschar, and gangreneCallus formation at pressure pointsRecording tissue type percentages in notesLesson 3Vascular assessment for lower extremity wounds: palpation of pulses, capillary refill, ABI, TBI, toe pressuresCovers bedside vascular assessment of the lower limb in diabetic patients. Includes pulse palpation, capillary refill, ankle-brachial index, toe pressures, and interpretation limits in calcified vessels and mixed disease common in Indian populations.
Inspection for color, hair, and trophic changesPalpation of pedal and posterior tibial pulsesCapillary refill and limb temperature checksPerforming and interpreting ABI in diabetesToe pressures and TBI for calcified arteriesWhen to refer for vascular imaging or consultLesson 4Infection and inflammation recognition: local vs systemic signs, using IDSA/International Working Group on the Diabetic Foot (IWGDF) criteriaFocuses on recognising infection and inflammation in diabetic foot wounds. Differentiates colonisation from infection, reviews local and systemic signs, and applies IDSA and IWGDF criteria to grade severity and guide action in busy clinics.
Normal healing inflammation versus infectionLocal signs in neuropathic and ischemic tissueSystemic signs and sepsis red flagsIDSA and IWGDF infection classificationWhen to obtain cultures and imagingUrgent referral criteria for limb-threatening casesLesson 5Relevant medical history and social determinants: glycaemic control, comorbidities, mobility, footwear, living situation, access to transport and careReviews key medical history and social determinants that influence diabetic foot wounds. Emphasises glycaemic control, comorbidities, mobility, footwear, home setting, and access to transport and timely wound care services in urban and rural India.
Targeted diabetes and treatment historyCardiovascular, renal, and neuropathy comorbiditiesMobility limits and fall or trauma historyFootwear type, fit, and wear patternsHome safety, support, and self-care capacityTransport, finances, and access to wound careLesson 6Standardised wound assessment frameworks (SITE, TIME, WoundBed, and Bates-Jensen)Introduces major wound assessment frameworks used in diabetic foot care, including SITE, TIME, WoundBed, and Bates-Jensen. Compares components, scoring, and how they support monitoring and interdisciplinary communication in team-based care.
Purpose of structured wound assessment toolsSITE framework elements and scoringTIME framework for wound bed preparationKey items in the WoundBed scoring systemBates-Jensen Wound Assessment overviewChoosing and applying a framework in practiceLesson 7Documentation standards and wound photography: consent, consistent lighting, orientation and measurement recordingDescribes best practices for written documentation and wound photography. Covers consent, privacy, positioning, lighting, scale placement, and consistent orientation to ensure reliable comparison and legal-quality records in Indian hospitals.
Essential elements of wound chartingLegal and ethical aspects of documentationObtaining and recording photo consentStandard patient positioning and landmarksLighting, focus, and use of measurement scalesSecure storage and labeling of wound imagesLesson 8Pain assessment in neuropathic and ischaemic feet: scales and bedside techniquesExplores pain assessment in neuropathic and ischaemic diabetic feet. Reviews pain scales, descriptors, and bedside manoeuvres that distinguish neuropathic burning from ischaemic rest pain, guiding analgesia and referral decisions for patients.
Common pain patterns in diabetic foot diseaseNumeric and visual pain rating scalesNeuropathic pain descriptors and screening toolsFeatures of ischemic and rest pain at nightAssessing pain during dressing changesDocumenting pain response to interventionsLesson 9Neuropathy evaluation: monofilament testing, vibration (tuning fork), pinprick and proprioception testsOutlines structured neuropathy assessment in diabetic feet using monofilament, vibration, pinprick, and proprioception tests. Emphasises technique, scoring, and how sensory loss alters risk and patient education needs in community settings.
Screening questions for neuropathic symptoms10 g monofilament sites and applicationVibration testing with tuning fork techniquePinprick and temperature discrimination testsProprioception and balance assessmentRisk stratification based on sensory lossLesson 10Measuring wound dimensions, depth, and tunnelling: tools and techniques (ruler, tracing, photography)Provides practical methods to measure wound length, width, depth, and tunnelling. Compares paper rulers, probes, tracings, and digital photography, stressing infection control and consistent technique between assessors in varied facilities.
Selecting clean, single-use measuring toolsStandardizing length, width, and clock faceSafe depth and tunneling probing techniqueUsing wound tracings and acetate templatesClinical photography for serial comparisonRecording measurements and trends over time
