D06: Palliative & Conservative Limb Care

Almost everything else in diabetic foot care aims to keep the limb and heal the wound. This module is for when that aim is no longer achievable, no longer safe or no longer what the patient wants. Three groups arrive here: people with no-option chronic limb-threatening ischaemia, the frail or dying patient with a foot wound, and the competent patient who declines salvage.

The module gives an algorithm for deciding the goal of care, built on honest prognosis, the patient's values and naming every option, including that a timely amputation can be the most palliative choice. It teaches classifying wounds as healable, maintenance or non-healable, keeping a stable dry eschar dry, multimodal analgesia without withholding opioids in life-limiting illness, regional nerve blocks for severe rest pain, and topical metronidazole with charcoal dressings for malodour. It covers integrating specialist palliative care alongside vascular care and relaxing glycaemic targets near the end of life.

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