B08: Advanced & Adjunctive Wound Therapies

In real-world data, only 30 to 40% of diabetic foot ulcers have healed at 12 weeks, and the hard-to-heal minority is why advanced therapies exist. The skill is not knowing the newest product. It is identifying which wounds are truly non-healing rather than under-treated, and escalating them in proportion. An adjunct is an addition to optimised standard care, never a replacement for it.

The module teaches a sequential gate before any adjunct: perfusion, infection, debridement and offloading checked first, then a trajectory of less than 50% area reduction over four weeks of good care. It works through the evidence adjunct by adjunct, including TLC-NOSF for neuroischaemic ulcers, negative pressure therapy for post-surgical cavities, membranes and skin substitutes, topical and hyperbaric oxygen, and the leucocyte-platelet-fibrin patch, with GRADE certainty for each. It covers when not to use an adjunct, such as routine becaplermin, shared decision-making and audit of adjunct use.

Content is tiered at Foundation, Core and Advanced level, with two decision algorithms and case vignettes. You receive the Teaching Document, the Evidence Base, the slide deck, a narrated video and an audio overview.