Mills et al reported the Society for Vascular Surgery Lower Extremity Threatened Limb Classification System. This consists of 3 components (wound, ischemia and foot infection). 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 involving a lower extremity
Parameters for measuring the size of a wound:
(1) depth based on anatomic structure
(2) depth based on distance in mm
(3) surface area in square centimeters
Anatomic depth:
(1) superficial (skin, subcutaneous fat)
(2) intermediate (fascia and muscle)
(3) deep (bone, tendon, joint)
In general, the depth of the ulcer is used for grading.
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Surface Area
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Description
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< 5 square cm
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small
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5 to 10 square cm
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medium
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> 10 square cm
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large
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rough approximation of wound volume in cubic centimeters =
= (area in square cm) * (depth in mm) / 10
When considering outcome healing can be judged by:
(1) reduction in anatomic depth
(2) reduction in vertical depth in millimeters
(3) reduction in surface area or wound volume.
percent of wound remaining =
= (current volume) / (original volume) * 100%
