Table 1 Diabetic foot evaluation and treatment system
From: A novel assessment, diagnostic and treatment system for diabetic foot
Ulcer grade | 0 | 1 | 2 | 3 | 4 |
|---|---|---|---|---|---|
CHARACTERISTICS | |||||
DEPTH | No ulcer | Epidermis/Dermis | G1 + Subcutaneous tissue | G2 + Fascia/Muscle/Bone | G3 + Critical ischaemia? Yes/No |
Warmth, oedema, erythema. DISMISS | Signs of ischemiaa | Signs of ischemiaa | Signs of ischemiaa | and/or Necrosis areas | |
INFECTION? | Assess | No | Superficial | Deep/Located | and/or Systemic toxicity |
EVALUATION | Neuroischemic screenig Skin thermometry | Neuroischemic screening | Neuroischemic screening | Neuroischemic screening | Neuroischemic screening |
Charcot Neuro-arthropathy? Image diagnosis | Microbiological Culture | Microbiological Culture | Microbiological Culture | ||
Probe to bone | Probe to bone | Probe to bone | |||
TREATMENT | Suspicion of Charcot neuro-arthropathy: | Debridement, surgery | Debridement and/or Revascularization | ||
Oral antibiotic | Oral antibiotic/IV | Antibiotic IV | |||
Tie up | Dressings | Dressings | Dressings | Dressings | |
Surgery? | Offloading | Offloading | Offloading | ||
Relative rest | Absolute rest | ||||
CARE LEVEL | Primary care/ DFU/ Hospital | Primary care | Primary care/ DFU | DFU/ Hospital | Hospital/ DFU |
DIABETES EDUCATION | Review | Review | Review | Review | Review |