15 April 2011

Diabetic Foot Ulcers Classification

Diabetic foot is the leading cause of hospitalization and amputation in diabetic patients today. Despite contributing to morbidity and mortality of patients with diabetes significantly, the diabetic foot is not yet bound by a universally accepted classification system. Some classification systems have been introduced, but they have not been accepted without reserve and are used sporadically at best.Why is it important to classify the diabetic foot?Foot ulceration is naturally of hospitalization. Ulcers are heterogeneous in terms of depth and tissue, etiology, intensity, depth and circumstances associated with participation. The presence or absence of infection depends on a number of these factors. Treatment methods also differ accordingly. That is why classification is essential to predict the outcome of the ulcer. The classifications to communicate the depth and severity of ulcers and offer an easy way to transmit changes for better or for worse.Any system of classification must have certain characteristics such as flexibility, precision, specificity, and simplicity. A classification of easy-to-use system gives us a uniform description of ulcer. Known and widely accepted classification systems include: WagnerMerck ManualSystème of the University of the Frykberg Texas.Classification and the ColemanWagner is the most widely accepted system. It is based on the presence of gangrene, the depth of penetration and extent of tissue necrosis. According to this system, a disease of rank-0 is one in which the skin shows signs of healed scars and also pre-ulcerative lesions or signs of deformation of bone which will lead to the formation of callus exhibitions.With that the different stages of the disease with four subdivisions in each category, A Grade1, Grade 1-B, Grade 1-C and Grade 1 - D, for example the base indication, classification marks. In General, ulcers of Grade-1 are superficial ulcers in which the skin shows damage, but the infection has not penetrated in the underlying tissue. Grade 2 ulcers are deep, because the infection has already penetrated the muscles and ligaments but have not yet reached the bone. Rank-3 ulcers are deep abscesses which show the formation of cellulitis and osteomyelitis. 4Th and 5th grade students indicate danger areas and have no categories. 4Th, gangrene is localized. In the 5th year, gangrene has affected the entire foot.There is however a major disadvantage to this system - do not address two important facets of the disease - infection and ischemia.Alternatively, the second most widely accepted system of classification is the classification of diabetic wound of the University of Texas. This system takes into account the depth of the ulcer, the presence of infection and the presence of ischemia. This system of categories ulcers of 0-3, taking into account these factors. The UT (University of Texas) system combines the grade and stage and therefore more intuitive.Research shows that a system of classification of ulcer right foot helps to predict clinical outcome. The highest rank, is more risk and more the number of amputations performed.In the case of the foot ulcers adhering to a strict regime of classification of diagnosis can improve communication between your family doctor and the diabetic specialist. This team eventually approach will lead to a decrease of complications and possibly to avoid amputations.