Diyabetik Ayak Ülserlerinin Sınıflandırma Sistemleri ve Seçimi

Yıl 2023, Cilt: 2 Sayı: 3, 21 - 30, 18.01.2024

Aykut Turgut Arzu İlçe

Öz

Diyabetik ayak ülserleri, dünya genelinde hızla artan yüksek prevalansları ve alt ekstremite amputasyonları gibi ciddi komplikasyonlarla ilişkileri nedeniyle önemli bir sağlık sorunudur. Diyabetik ayak ülserlerinin etkin yönetimi, bu ülserlerin doğru bir şekilde değerlendirilmesine ve sınıflandırılmasına bağlıdır. Bu konuda sınıflandırma sistemleri, diyabetli bireylerde ayak ülserlerinin değerlendirilmesi ve yönetiminin standardize edilmesinde önemli bir rol oynamaktadır. Bu sınıflandırmalar, klinik uygulamalarda tutarlı bir dil oluşturmayı amaçlamakta ve etkili tedavi stratejilerini belirlemede kılavuz olarak kullanılabilmektedir. Bu derlemede, diyabetik ayak ülserlerinin sınıflandırma sistemlerinin kapsamlı bir özeti sunulmuş olup, klinik uygulamalara yönelik bilgi sağlaması amaçlanmaktadır.

Anahtar Kelimeler

Ayak Ülseri, Diabetes Mellitus, Diyabetik Ayak, Sınıflandırma

Classification Systems for Diabetic Foot Ulcers and Their Selection

Öz

Diabetic foot ulcers are an important health problem due to their rapidly increasing high prevalence worldwide and their association with serious complications such as lower limb amputations. Effective management of diabetic foot ulcers depends on accurate assessment and classification of these ulcers. In this regard, classification systems play an important role in standardizing the assessment and management of foot ulcers in individuals with diabetes. These classifications aim to create a consistent language in clinical practice and can be used as a guide in determining effective treatment strategies. This review provides a comprehensive summary of the classification systems of diabetic foot ulcers and aims to inform clinical practice.

Anahtar Kelimeler

Foot Ulcer, Diabetes Mellitus, Diabetic Foot, Classification

Kaynakça

• Alsabek, M. B., & Abdul Aziz, A. R. (2022). Diabetic foot ulcer, the effect of resource‐poor environments on healing time and direct cost: A cohort study during Syrian crisis. International Wound Journal, 19(3), 531–537. https://doi.org/10.1111/iwj.13651
• Armstrong, D. G., Lavery, L. A., & Harkless, L. B. (1998). Validation of a Diabetic Wound Classification System: The contribution of depth, infection, and ischemia to risk of amputation. Diabetes Care, 21(5), 855–859. https://doi.org/10.2337/diacare.21.5.855
• Boulton, A. J. M. (2014). Diabetic neuropathy and foot complications. In Handbook of Clinical Neurology (1st ed., Vol. 126, Issue 1936). Elsevier B.V. https://doi.org/10.1016/B978-0-444-53480-4.00008-4
• Buke, C. (2017). Current Treatment of Diabetic Foot Infections and the Effect of Dermobor. Cyprus Journal of Medical Sciences, 2(2), 29–34. https://doi.org/10.5152/cjms.2016.230
• Bus, S. A., & van Netten, J. J. (2016). A shift in priority in diabetic foot care and research: 75% of foot ulcers are preventable. Diabetes/Metabolism Research and Reviews, 32, 195–200. https://doi.org/10.1002/dmrr.2738
• Chuan, F., Tang, K., Jiang, P., Zhou, B., & He, X. (2015). Reliability and validity of the perfusion, extent, depth, infection and sensation (PEDIS) classification system and score in patients with diabetic foot ulcer. PLoS ONE, 10(4). https://doi.org/10.1371/journal.pone.0124739
• Dath, R., Rao, U. V., Kumar, K., Kumar, H., & Kumar, S. (2017). Offloading of diabetic foot wounds using Amit Jain’s offloading system: an experience of 23 cases. International Surgery Journal, 4(8), 2777. https://doi.org/10.18203/2349-2902.isj20173417
• Dianna Magliano, Edward J. Boyko, & International Diabetes Federation. (2021). IDF diabetes atlas (10th ed.). International Diabetes Federation. http://www.ncbi.nlm.nih.gov/books/NBK581934/
• Dinker R Pai, S. S. (2013). Diabetic Foot Ulcer – Diagnosis and Management. Clinical Research on Foot & Ankle, 01(03). https://doi.org/10.4172/2329-910x.1000120
• Ghotaslou, R., Memar, M. Y., & Alizadeh, N. (2018). Classification, microbiology and treatment of diabetic foot infections. Journal of Wound Care, 27(7), 434–441. https://doi.org/10.12968/jowc.2018.27.7.434
• Habbash, F., Saeed, A., Abbas, F., Ajlan, B. Y., Abdulla, F., & Alsayyad, A. S. (2019). Knowledge and Practice Regarding Foot Care in Patients With Diabetes Mellitus Attending Diabetic Clinics in Health Centers in the Kingdom of Bahrain. International Journal of Medicine and Public Health. https://doi.org/10.5530/ijmedph.2019.4.32
• Hicks, C. W., Canner, J. K., Mathioudakis, N., Sherman, R., Malas, M. B., Black, J. H., & Abularrage, C. J. (2018). The Society for Vascular Surgery Wound, Ischemia, and foot Infection (WIfI) classification independently predicts wound healing in diabetic foot ulcers. Journal of Vascular Surgery, 68(4), 1096–1103. https://doi.org/10.1016/j.jvs.2017.12.079
• Ince, P., Abbas, Z. G., Lutale, J. K., Basit, A., Ali, S. M., Chohan, F., Morbach, S., Org, J. ¨, Ollenberg, M. ¨, Game, F. L., & Jeffcoate, W. J. (2008). Use of the SINBAD Classification System and Score in Comparing Outcome of Foot Ulcer Management on Three Continents. http://diabetesjournals.org/care/article-pdf/31/5/964/599464/zdc00508000964.pdf
• Jain, A., & Joshi, S. (2013). Diabetic Foot Classifications: Review of Literature. Medicine Science | International Medical Journal, 2(3), 715. https://doi.org/10.5455/medscience.2013.02.8069
• Jain, A. K. C. (2017). AMIT JAIN’S CODING SYSTEM FOR DIABETIC FOOT ULCER. International Journal of Medical Science and Clinical Inventions, 4(7). https://doi.org/10.18535/ijmsci/v4i7.16
• Jain, A. K. C., HC, A., Kumar, S., & TR, H. (2019). Distribution and analysis of Charcot foot in diabetes through Amit Jain’s extended “SCC” classification. National Journal of Clinical Orthopaedics, 3(4), 08–15. https://doi.org/10.33545/orthor.2019.v3.i4a.173
• Kumar, A., & Jain, C. (2012). A NEW CLASSIFICATION OF DIABETIC FOOT COMPLICATIONS: A SIMPLE AND EFFECTIVE TEACHING TOOL. In The Journal of Diabetic Foot Complications (Vol. 4, Issue 1).
• M. E. Edmonds, & Alethea V. M. Foster. (2000). Managing the diabetic foot. Blackwell Science.
• Margolis, D. J., Allen‐Taylor, L., Hoffstad, O., & Berlin, J. A. (2005). Diabetic neuropathic foot ulcers and amputation. Wound Repair and Regeneration, 13(3), 230–236. https://doi.org/10.1111/j.1067-1927.2005.130303.x
• Matilde Monteiro-Soares, & João Vasco Santos. (2022). IDF Atlas Reports Diabetes foot-related complications. https://diabetesatlas.org/atlas/diabetic-foot-2022/
• Merheb, M., Gharios, E., Younes, A., Cheikh, M. Al, & Chaaban, T. (2017). Effect of total contact cast in non-healing diabetic foot ulcers in Lebanese patients. International Wound Journal, 14(5), 751–753. https://doi.org/10.1111/iwj.12660
• Mohamed Alaa Elden, S., Wadie El-Gawly, H., Salem, A., Sliem, H., & Gamal Bagdady, E. (2014). SCREENING TECHNIQUES TO IDENTIFY OCCURRENCE OF DIABETIC FOOT ULCERATION AMONG PEOPLE AT HIGH RISK. In Port Said Scientific Journal of Nursing (Vol. 1, Issue 2).
• Monteiro-Soares, M., Russell, D., Boyko, E. J., Jeffcoate, W., Mills, J. L., Morbach, S., & Game, F. (2020). Guidelines on the classification of diabetic foot ulcers (IWGDF 2019). Diabetes/Metabolism Research and Reviews, 36(S1). https://doi.org/10.1002/dmrr.3273
• Oyibo, S. O., Jude, E. B., Tarawneh, I., Nguyen, H. C., Armstrong, D. G., Harkless, L. B., & Boulton, A. J. M. (2001). The effects of ulcer size and site, patient’s age, sex and type and duration of diabetes on the outcome of diabetic foot ulcers. Diabetic Medicine, 18(2), 133–138. https://doi.org/10.1046/j.1464-5491.2001.00422.x
• P. B., S., Krishnappa, R., Jain, A. K. C., & Ramachandra, H. T. (2020). A comparative study of primary cellulitis and its local complications in lower limbs in diabetics and non-diabetics through the new Amit Jain’s staging system from India. International Surgery Journal, 7(6), 1962. https://doi.org/10.18203/2349-2902.isj20202413
• Pickwell, K., Siersma, V., Kars, M., Apelqvist, J., Bakker, K., Edmonds, M., Holstein, P., Jirkovská, A., Jude, E., Mauricio, D., Piaggesi, A., Ragnarson Tennvall, G., Reike, H., Spraul, M., Uccioli, L., Urbancic, V., van Acker, K., van Baal, J., & Schaper, N. (2015). Predictors of Lower-Extremity Amputation in Patients With an Infected Diabetic Foot Ulcer. Diabetes Care, 38(5), 852–857. https://doi.org/10.2337/dc14-1598
• Praveena D.L., Uppin, S. M., & Shimikore, S. S. (2018). A one year cross sectional study on role of Wagner’s classification in predicting the outcome in diabetic foot ulcer patients. International Surgery Journal, 5(7), 2537. https://doi.org/10.18203/2349-2902.isj20182769
• Robbie, J., Edmonds, M., Phillips, A., Odiase, C., Beckwith, A., Diggle, J., Holmes, P., Grummitt, J., & Walker, K. (2022). ACT NOW: a practical toolkit for amputation reduction. British Journal of Healthcare Management, 28(5), 112–117. https://doi.org/10.12968/bjhc.2022.0055
• S., G., & S. J., H. (2019). Amit Jain’s system of practice for diabetic foot: the modern diabetic foot surgery. International Journal of Research in Orthopaedics, 5(3), 532. https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20191797
• Santema, T. B., Lenselink, E. A., Balm, R., & Ubbink, D. T. (2016). Comparing the meggitt-wagner and the university of texas wound classification systems for diabetic foot ulcers: Inter-observer analyses. International Wound Journal, 13(6), 1137–1141. https://doi.org/10.1111/iwj.12429
• Schäfer, Z., Mathisen, A., Svendsen, K., Engberg, S., Rolighed Thomsen, T., & Kirketerp-Møller, K. (2021). Toward Machine-Learning-Based Decision Support in Diabetes Care: A Risk Stratification Study on Diabetic Foot Ulcer and Amputation. Frontiers in Medicine, 7. https://doi.org/10.3389/fmed.2020.601602
• Schaper, N. C. (2004). Diabetic foot ulcer classification system for research purposes: A progress report on criteria for including patients in research studies. Diabetes/Metabolism Research and Reviews, 20(SUPPL. 1). https://doi.org/10.1002/dmrr.464
• van Reijen, N. S., Ponchant, K., Ubbink, D. T., & Koelemay, M. J. W. (2019). Editor’s Choice – The Prognostic Value of the WIfI Classification in Patients with Chronic Limb Threatening Ischaemia: A Systematic Review and Meta-Analysis. European Journal of Vascular and Endovascular Surgery, 58(3), 362–371. https://doi.org/10.1016/j.ejvs.2019.03.040
• Venkataramana, A. V. H., B. D., M., Razack, A., H. R., H., & Arish, H. (2020). A prospective study to determine the application of site, ischemia, neuropathy, bacterial infection and depth scoring in the outcome and management of diabetic foot ulcers. International Surgery Journal, 7(2), 478. https://doi.org/10.18203/2349-2902.isj20200301
• Zhan, L. X., Branco, B. C., Armstrong, D. G., & Mills, J. L. (2015). The Society for Vascular Surgery lower extremity threatened limb classification system based on Wound, Ischemia, and foot Infection (WIfI) correlates with risk of major amputation and time to wound healing. Journal of Vascular Surgery, 61(4), 939–944. https://doi.org/10.1016/j.jvs.2014.11.045
• Zhu, C., Yue, P., Lü, J., Liu, X., Huo, L., & Zhang, Z. (2019). Treatment of Diabetic Foot Gangrene Using the STAGE Principle: A Case Series. International Journal of Lower Extremity Wounds, 18(2), 200–207. https://doi.org/10.1177/1534734619840584