Diabetic foot ulcer

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Background

  • Foot ulcer in a patient with diabetes mellitus
  • Pathophysiology is from minor trauma in the context of:
    • Neuropathy: sensory, motor, and autonomic
    • Arteriopathy
    • Immune dysfunction

SINBAD system

  • Simple scoring system used for triaging diabetic foot ulcer
Criterion Value Score
Site Forefoot 0
Midfoot or hindfoot 1
Ischemia Pedal blood flow intact, with at least one palpable pulse 0
Clinical evidence of reduced pedal flow 1
Neuropathy Protective sensation intact 0
Protective sensation lost 1
Bacterial infection Absent 0
Present 1
Area of ulcer Ulcer <1 cm2 0
Ulcer ≥1 cm2 1
Depth Confined to skin and subcutaneous tissue 0
Reaching muscle, tendon, or deeper 1

Further Reading