1. Wound Assessment Using the LADD SECO Model
Bryan Levay
HSCI 5108: Instructional Media
Summer 2013

2. Overview Importance of wound care Lecture Describe wounds Activity
Evaluation

3. Importance of wound care
15-25% of all diabetics will have an ulcer in their lifetime
Recurrence rate 40%
Amputation
85% of lower-extremity amputation are preceded by an ulcer
5-year mortality rate following a BKA is ~50%
Amputation have varying psychosocial issues accompanying
Most amputations are preventable

4. Diabetic foot ulceration
Neuropathic
Neuropathy
Deformity
Minor trauma
This is basic information provided in previous courses

5. Summary 2nd-year DO & DPM students Objectives Technologies
Basic knowledge from previous courses
Objectives
Identify DFU from non-DFU
Verbally and transcribe the wound description with LADD SECO criteria
Be able to explain 7 of 8 components of LADD SECO
Technologies
Computer, MS Word, PPT, Blackboard access

6. Learning module 2-hour lecture 2-hour activity Basic information
Intro to LADD SECO
2-hour activity
5-item exercise packet
Evaluation

7. Lecture Traditional learning 2-hour
Lecture hall 2 of the HEC at WesternU
Certified Wound Specialist
Reinforce previous knowledge
Introduce LADD SECO

8. LADD SECO
Location
Aspect
Dimensions
Drainage
Shape
Edge
Color
Other

9. Location Where is the wound located?

10. Aspect What aspect of the body is it located?
Example: Inside, outside, front, rear
Like location, it distinguishes position

11. Drainage Is there any drainage coming out?
Example: purulent, serous, blood

12. Dimensions What are the dimensions of the wound?
Length x Width x Depth
Metric only

13. Shape How is the wound shaped? Example: circular, linear, irregular

14. Edge How does the wound edges appear?
Example: macerated, callused, necrotic

15. Color What is the color of the wound base?
Example: Red, white, yellow, black

16. Other Other things you notice? Warmth? Odor? Satellite wounds?
Tunneling?
Periwound area?

17. Activity 2-hour session 6-8 students per break out room
1-2 DPM, 5-6 DO
5 cases with image
Individual needs to complete
Rounding faculty will provide assistance
See worksheet

18. Evaluation
Speak about evaluation

19. Student feedback
Show student evaluation

20. References
American Diabetes Association. (2013). Economic Costs of Diabetes in U.S. in Diabetes Care, 36(4), doi: /dc
Armstrong, D. G., Nguyen, H. C., Lavery, L. A., van Schie, C. H. M., Boulton, A. J. M., & Harkless, L. B. (2001). Off-loading the diabetic foot wound: A randomized clinical trial. Diabetes Care, 24(6), Retrieved from
Bryant, R. A., & Nix, D. P. (Eds.). (2003). Acute & chronic wounds: Current management concepts (3 ed.). St. Louis, Missouri: Mosby Elsevier.
Bumpus, K., & Maier, M. A. (2013). The ABC’s of wound care. Current Cardiology Reports. Advance online publication. doi: /s
Carls, G. S., Gibson, T. B., Driver, V. R., Wrobel, J. S., Garoufalis, M. G., DeFrancis, R. R., Christina, J. R. The economic value of specialized lower-extremity medical care by podiatric physicians in the treatment of diabetic foot ulcers. Journal of the American Podiatric Medical Association, 101(2), Retrieved from
Cavanagh, P. R., & Bus, S. A. (2010). Off-loading the diabetic foot for ulcer prevention and healing (Supplemental material). Plastic and Reconstructive Surgery, 127(1S), 248S-256S. doi: /PRS.0b013e
Harkless, L., & Holmes, C. (2004). Linking risk factors: The role of history in predicting outcome. The Diabetic Foot, 7(3), Retrieved from
Leung, P. C. (2007). Diabetic foot ulcers – a comprehensive review. Surgeon, 5(4), Retrieved from
Ramsey, S. D., Newton, K., Blough, D., McCulloch, D. K., Sandhu, N., Reiber, G. E., & Wagner, E. H. (1999). Incidence, outcomes, and cost of foot ulcers in patients with diabetics. Diabetes Care, 22(3), Retrieved from
Rhim, B., & Harkless, L. (2012). Prevention: Can we stop problems before they arise? Seminars in Vascular Surgery, 25(2), doi: /j.semvascsurg

21. Questions?