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Description

Mills et al reported the Society for Vascular Surgery Lower Extremity Threatened Limb Classification System. This consists of 3 components, one of which is a foot infection grade. The authors are from the University of Arizona, the University of California San Francisco, St. Elizabeth's Medical Center (Brighton, Mass), the University of Massachusetts, George Washington University and Valley Presbyterian Medical Center (Van Nuys).


Patient selection: peripheral arterial disease of a lower extremity

 

Signs of local infection - 2 or more of the following:

(1) local swelling or induration

(2) erythema around wound

(3) local tenderness or pain

(4) local warmth

(5) purulent discharge (sanguinous, thick whitish)

 

Signs of SIRS (systemic inflammatory response syndrome) - 2 or more of the following:

(1) temperature < 36°C or > 38°C

(2) heart rate > 90 beats per minute

(3) (respiratory rate > 20 breaths per minute) OR (PaCO2 < 32 mm Hg)

(4) (WBC count < 4,000 or > 12,000 per µL) OR (> 10% band forms)

 

Signs of Infection

Comment

Grade

none

 

0

superficial, limited to skin and subcutaneous tissue

erythema 0.51 to 2.0 cm around ulcer

1

superficial

erythema > 2 cm

2

deep

no signs of systemic infection

2

local or deep with signs of SIRS

 

3

 


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