Martinez-De Jesus reported a 10-item checklist for evaluating a diabetic food ulcer. This measures the severity and extent of foot involvement. The author is from Centro de Prevencion y Salvamento de Pie diabetico San Elian in Mexico.
Patient selection: diabetic foot ulcer
Sections:
(1) anatomical - first 3 questions
(2) aggravating factors - questions 4 to 7
(3) affected tissues - last 3 questions
Parameters:
(1) location
(2) topographical aspects
(3) affected zones
(4) ischemia
(5) infection
(6) edema
(7) neuropathy
(8) depth
(9) area in square cm
(10) wound healing phase
|
Parameter |
Finding |
Points |
|
location |
phalangeal/digits |
1 |
|
|
metatarsal |
2 |
|
|
tarsal |
3 |
|
topographical aspects |
dorsal or plantar |
1 |
|
|
lateral or medial |
2 |
|
|
2 or more |
3 |
|
affected zones |
1 |
1 |
|
|
2 |
2 |
|
|
entire foot (multiple) |
3 |
|
ischemia |
none |
0 |
|
|
mild |
1 |
|
|
moderate |
2 |
|
|
severe |
3 |
|
infection |
none |
0 |
|
|
mild |
1 |
|
|
moderate |
2 |
|
|
severe (SIRS) |
3 |
|
edema |
none |
0 |
|
|
periwound |
1 |
|
|
affected limb only |
2 |
|
|
bilateral (systemic disease) |
3 |
|
neuropathy |
none |
0 |
|
|
protective sensory or vibration reduced |
1 |
|
|
loss of protective |
2 |
|
|
Charcot foot |
3 |
|
depth |
superficial |
1 |
|
|
deep (below dermis) |
2 |
|
|
all layers (into bone or joint) |
3 |
|
area |
< 10 square cm |
1 |
|
|
10 to 40 sq cm |
2 |
|
|
> 40 sq cm |
3 |
|
wound healing phase |
epithelialization |
1 |
|
|
granulation tissue |
2 |
|
|
inflammatory |
3 |
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 6
• maximum score: 30
|
Score |
Grade |
Prognosis |
|
6 to 10 |
I (mild) |
probable healing |
|
11 to 20 |
II (moderate) |
partial foot-threatening outcome; depends on therapy and host defenses |
|
21 to 30 |
III (severe) |
limb or life threatening |
Specialty: Dermatology
