Diabetic foot classification: Difference between revisions
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==Classification== | ==Classification== | ||
*[[Diabetic foot]] [[infections]] are classified according to the severity of involvement to assist with clinical decision-making regarding the need for [[mouth|oral]] or [[Route of administration|parenteral]] [[antibiotics]], outpatient management | *[[Diabetic foot]] [[infections]] are classified according to the severity of involvement to assist with clinical decision-making regarding the need for [[mouth|oral]] or [[Route of administration|parenteral]] [[antibiotics]], [[patient|outpatient]] management, need for [[Hospital|hospitalization]], and [[surgery|surgical intervention]].<ref name="Dinker R Pai2013">{{cite journal|last1=Dinker R Pai|first1=Simerjit Singh|title=Diabetic Foot Ulcer – Diagnosis and Management|journal=Clinical Research on Foot & Ankle|volume=01|issue=03|year=2013|issn=2329910X|doi=10.4172/2329-910X.1000120}}</ref> | ||
*The Infectious Disease Society of America (IDSA) introduced a classification scheme for these [[infections]] in their 2004 guidelines, broadly categorized as mild, moderate, and severe [[infections]] based upon the extent of [[infection]] and [[inflammation]].<ref name="pmid22619242">{{cite journal| author=Lipsky BA, Berendt AR, Cornia PB, Pile JC, Peters EJ, Armstrong DG et al.| title=2012 Infectious Diseases Society of America clinical practice guideline for the diagnosis and treatment of diabetic foot infections. | journal=Clin Infect Dis | year= 2012 | volume= 54 | issue= 12 | pages= e132-73 | pmid=22619242 | doi=10.1093/cid/cis346 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22619242}} </ref> | *The Infectious Disease Society of America (IDSA) introduced a classification scheme for these [[infections]] in their 2004 guidelines, broadly categorized as mild, moderate, and severe [[infections]] based upon the extent of [[infection]] and [[inflammation]].<ref name="pmid22619242">{{cite journal| author=Lipsky BA, Berendt AR, Cornia PB, Pile JC, Peters EJ, Armstrong DG et al.| title=2012 Infectious Diseases Society of America clinical practice guideline for the diagnosis and treatment of diabetic foot infections. | journal=Clin Infect Dis | year= 2012 | volume= 54 | issue= 12 | pages= e132-73 | pmid=22619242 | doi=10.1093/cid/cis346 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22619242}} </ref> | ||
*The International Working Group on the [[Diabetic Foot]] (IWGDF) published a similar classification system in 2012.<ref name="pmid22271739">{{cite journal|author=Lipsky BA, Peters EJ, Senneville E, Berendt AR, Embil JM, Lavery LA, Urbancic-Rovan V, Jeffcoate WJ|title=Expert opinion on the management of infections in the diabetic foot.|journal=Diabetes Metab Res Rev|year=2012|volume=28|issue=1|pages=163-78|pmid=22271739|doi=|url=http://www.ncbi.nlm.nih.gov/pubmed/22271739}}</ref> | *The International Working Group on the [[Diabetic Foot]] (IWGDF) published a similar classification system in 2012.<ref name="pmid22271739">{{cite journal|author=Lipsky BA, Peters EJ, Senneville E, Berendt AR, Embil JM, Lavery LA, Urbancic-Rovan V, Jeffcoate WJ|title=Expert opinion on the management of infections in the diabetic foot.|journal=Diabetes Metab Res Rev|year=2012|volume=28|issue=1|pages=163-78|pmid=22271739|doi=|url=http://www.ncbi.nlm.nih.gov/pubmed/22271739}}</ref> |
Revision as of 08:54, 11 July 2021
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Daniel A. Gerber, M.D. [2] Anahita Deylamsalehi, M.D.[3]
Overview
Diabetic foot is classified according to its severity and factors such as the requirement of oral or parenteral antibiotics, outpatient management or hospitalization, and surgical intervention.
Classification
- Diabetic foot infections are classified according to the severity of involvement to assist with clinical decision-making regarding the need for oral or parenteral antibiotics, outpatient management, need for hospitalization, and surgical intervention.[1]
- The Infectious Disease Society of America (IDSA) introduced a classification scheme for these infections in their 2004 guidelines, broadly categorized as mild, moderate, and severe infections based upon the extent of infection and inflammation.[2]
- The International Working Group on the Diabetic Foot (IWGDF) published a similar classification system in 2012.[3]
- The aforementioned systems were externally validated in a longitudinal study to assess prognostic value, which demonstrated increased risk for amputation among patients with infections classified as severe.[4]
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- Another widely accepted diabetic foot ulcer classification is Wagner ulcer classification system, which uses some ulcer's features such as depth, in addition to presence of osteomyelitis or gangrene.[5]
Grade | Ulcer's Features |
---|---|
0 | Not an obvious open lesion |
1 | Superficial ulcer with partial or full thickness |
2 | Extension of ulcer to other structures such as tendon, ligament, joint capsule, or deep fascia (without abscesses or osteomyelitis) |
3 | Extension of ulcer to other structures such as tendon, ligament, joint capsule, or deep fascia with abscesses, osteomyelitis or septic arthritis |
4 | Presence of gangrene, but localized to forefoot or heel |
5 | Presence of extensive gangrene |
References
- ↑ Dinker R Pai, Simerjit Singh (2013). "Diabetic Foot Ulcer – Diagnosis and Management". Clinical Research on Foot & Ankle. 01 (03). doi:10.4172/2329-910X.1000120. ISSN 2329-910X.
- ↑ Lipsky BA, Berendt AR, Cornia PB, Pile JC, Peters EJ, Armstrong DG; et al. (2012). "2012 Infectious Diseases Society of America clinical practice guideline for the diagnosis and treatment of diabetic foot infections". Clin Infect Dis. 54 (12): e132–73. doi:10.1093/cid/cis346. PMID 22619242.
- ↑ Lipsky BA, Peters EJ, Senneville E, Berendt AR, Embil JM, Lavery LA, Urbancic-Rovan V, Jeffcoate WJ (2012). "Expert opinion on the management of infections in the diabetic foot". Diabetes Metab Res Rev. 28 (1): 163–78. PMID 22271739.
- ↑ Lavery LA, Armstrong DG, Murdoch DP, Peters EJ, Lipsky BA (2007). "Validation of the Infectious Diseases Society of America's diabetic foot infection classification system". Clin Infect Dis. 44 (4): 562–5. PMID 17243061.
- ↑ Wagner, F William (1987). "The Diabetic Foot". Orthopedics. 10 (1): 163–172. doi:10.3928/0147-7447-19870101-28. ISSN 0147-7447.
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