Diabetic foot classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Classification

Diabetic foot infection

DFI is classified based on its severity according to the Infectious Diseases Society of America (IDSA) guideline or the PEDIS grade developed by International Working Group on the Diabetic Foot (IWGDF).

Clinical Manifestation PEDIS Grade IDSA Severity No symptoms or signs of infection 1 Uninfected Local infection involving only the skin and the subcutaneous tissue without involvement of deeper tissues and without signs of SIRS If erythema, must be >0.5 cm to ≤2 cm around the ulcer. Exclude other causes of an inflammatory response of the skin (eg, trauma, gout, acute Charcot neuro-osteoarthropathy, fracture, thrombosis, venous stasis). 2 Mild Local infection with erythema >2 cm or involving structures deeper than skin and subcutaneous tissues (eg, abscess, osteomyelitis, septic arthritis, fasciitis) without signs of SIRS 3 Moderate Local infection with the signs of SIRS, as manifested by ≥2 of the following: Temperature >38 °C or <36 °C Heart rate >90 beats/min Respiratory rate >20 breaths/min or PaCO2 <32 mm Hg White blood cell count >12,000 or <4,000 cells/μL or ≥10% immature (band) forms 4 Severe

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