347 Implementing SINBAD Classification for Improved Documentation of Diabetic Foot Ulcers: A Quality Improvement Project

Abstract Background Proper documentation of diabetic foot ulcers (DFUs) is essential for assessing severity, planning treatment, and tracking outcomes. NICE guidelines recommend using a standardised system like SINBAD or the University of Texas classification. In our unit, structured documentation was rarely used. Aim To improve DFU documentation by introducing the SINBAD classification in line with NICE recommendations. Method We conducted a retrospective audit of all patients with DFUs admitted under the General Surgery team at Prince Digna Hospital, Port Sudan, Sudan. Baseline records were checked for the six SINBAD components: Site, Ischaemia, Neuropathy, Bacterial infection, Area, and Depth. Staff were then trained, and a SINBAD-based documentation template was introduced. Records were re-audited after the intervention. Results Before the intervention, compliance was low: Site 65%, Ischaemia 41%, Neuropathy 0%, Bacterial infection 35%, Area 58%, Depth 35%. None of the notes used a standardised system. After the intervention, all criteria were documented at 100% except neuropathy, which was documented in 62%. Assessment of neuropathy was limited by the lack of monofilament testing in Port Sudan, and clinical examination findings were not consistently reliable. Conclusions Using a structured SINBAD-based template significantly improved the completeness and consistency of DFU documentation, supporting adherence to NICE guidelines. Limited resources affected neuropathy assessment, highlighting the need for proper diagnostic tools. Routine use of the template and ongoing staff training are key to maintaining these improvements.