Open AccessValidation of a diabetic foot surgery classification
Author(s) -
Armstrong David G,
Lavery Lawrence A,
Frykberg Robert G,
Wu Stephanie C,
Boulton Andrew JM
Publication year - 2006
Publication title -
international wound journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.867
H-Index - 63
eISSN - 1742-481X
pISSN - 1742-4801
DOI - 10.1111/j.1742-481x.2006.00236.x
Subject(s) - medicine , amputation , diabetic foot , foot (prosody) , referral , diabetes mellitus , medical record , retrospective cohort study , cohort , surgery , linguistics , philosophy , family medicine , endocrinology
The purpose of this project was to evaluate associations of increasing diabetic foot surgery stage with postoperative outcome. This project, designed as a retrospective cohort model, was conducted at three large, urban referral‐based diabetic foot clinics. The investigators abstracted medical records from 180 patients with diabetes, 76·1% male, aged 57·8 ± 11·2 years, falling equally into four classes of a previously reported diabetic foot surgery classification system. These classes included class 1 (elective), class 2 (prophylactic), class 3 (curative) and class 4 (emergency). There was a significant trend towards increasing risk of ulceration/reulceration (χ 2 trend = 17·8, P = 0·0001), peri‐postoperative infection (χ 2 trend = 96·9, P = 0·0001), all‐level amputation (χ 2 trend = 41·7 P = 0·001) and major amputation (χ 2 trend = 8·6, P = 0·003), with increasing class of foot surgery. The results of this study suggest that a non vascular foot surgery classification system including variables such as the presence or absence of neuropathy, an open wound and acute infection may be predictive of peri‐ and postoperative complications. This may assist the surgeon in better identifying risk when determining a rationale for and type of surgery in persons with diabetes.