Reliability and Validity of the Perfusion, Extent, Depth, Infection and Sensation (PEDIS) Classification System and Score in Patients with Diabetic Foot Ulcer

Chuan, Fengning; Tang, Kang; Jiang, Peng; Zhou, Bo; He, Xiaoqun

doi:10.1371/journal.pone.0124739

Cited by 89 publications

(101 citation statements)

References 23 publications

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“…In addition, identifying patients with chronic wounds who meet inclusion criteria requires careful selection, with random sequence bias witnessed in studies using baseline as a control. Further, the Wagner classification scale chosen by the studies to categorise diabetic foot ulcers has been shown to be less reliable then other classification methods . For the studies featuring different chronic wounds, no classification scales for wound healing/severity were used by the authors.…”

Section: Discussionmentioning

confidence: 99%

Ozone therapy for the treatment of chronic wounds: A systematic review

Fitzpatrick

Holland

Vanderlelie

2018

International Wound Journal

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Chronic wounds present a significant burden to the health care system and the patient. Ozone therapy has been proposed as a treatment for chronic wounds, potentially acting by eliciting mild oxidative stress or disinfection. The purpose of this systematic review is to evaluate the potential benefits and harms of ozone therapy as an advanced care intervention for chronic wounds. Studies were extracted from Google Scholar, PubMed, the Cochrane Library, and reference lists. General inclusion criteria included English-language randomised human trials reporting the use of ozone therapy in the topical treatment of chronic wounds. Primary outcome data included the extent of chronic wound healing, and secondary outcomes included adverse effects. Studies were assessed for level of bias and data quality. Nine studies (n = 453 patients) matched the inclusion criteria and underwent meta-analysis. Overall, there was a significant improvement in wound closure with ozone therapy. Results consistently favour the application of ozone as a treatment for chronic wounds; however, there is no conclusive evidence of ozone therapy as superior compared with standard treatments. Compared with standard care, ozone therapy as an advanced wound care treatment may improve the proportion of chronic wounds healed in a shorter amount of time, but further research is required.

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Section: Discussionmentioning

confidence: 99%

Ozone therapy for the treatment of chronic wounds: A systematic review

Fitzpatrick

Holland

Vanderlelie

2018

International Wound Journal

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“…The guidelines suggest that the depth of the wound is an important parameter of the prognosis . In the PEDIS classification system, wound depth is categorised as skin intact, superficial, fascia–muscle–tendon and bone–joint.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for amputation in patients with diabetic foot infection: a prospective study

Uysal

Arda

Taşbakan

et al. 2017

International Wound Journal

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There is a variety of diagnostic and therapeutic algorithms for diabetic foot infections (DFIs). Some of them are too difficult to be applied in routine clinical approach. In the routine clinical approach, it is necessary to find new risk factors and end up with a quick and easy assessment of DFIs. In this study, we aimed to evaluate the independent risk factors for osteomyelitis, amputation and major amputation in patients with DFI using standard scoring procedures. We prospectively studied 379 patients with DFI. The variables were analysed using logistic analysis. A total of 126 cases (33·2%) underwent amputation. The odds ratios in the amputation model were 3·09 for osteomyelitis (P < 0·001), 4·90 for arterial stenosis (AS) (P < 0·001), 3·67 for the history of DFI (P = 0·001), 2·47 for ulcer duration >60 days (P = 0·001), 3·10 for ulcer depth > 15 mm (P < 0·001) and 10·28 for fungal DFI (P = 0·015). In this study, the unusual result of well-known literature was fungal DFI as an independent risk factor for amputation in patients with DFI.

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“…It does not include patient factors (end‐stage renal disease) or either the location or the number of foot ulcers. PEDIS has been validated in two studies for both wound healing and a composite endpoint of nonhealing, amputation, and death . It has also been demonstrated to have good reliability .…”

Section: Recommendations and Rationalementioning

confidence: 99%

Guidelines on the classification of diabetic foot ulcers (IWGDF 2019)

Monteiro‐Soares

Russell

Boyko

et al. 2020

Diabetes Metabolism Res

183

247

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The International Working Group on the Diabetic Foot (IWGDF) has been publishing evidence‐based guidelines on the prevention and management of diabetic foot disease since 1999. This publication represents a new guideline addressing the use of classifications of diabetic foot ulcers in routine clinical practice and reviews those which have been published. We only consider systems of classification used for active diabetic foot ulcers and do not include those that might be used to define risk of future ulceration. The guidelines are based on a review of the available literature and on expert opinion leading to the identification of eight key factors judged to contribute most to clinical outcomes. Classifications are graded on the number of key factors included as well as on internal and external validation and the use for which a classification is intended. Key factors judged to contribute to the scoring of classifications are of three types: patient related (end‐stage renal failure), limb‐related (peripheral artery disease and loss of protective sensation), and ulcer‐related (area, depth, site, single, or multiple and infection). Particular systems considered for each of the following five clinical situations: (a) communication among health professionals, (b) predicting the outcome of an individual ulcer, (c) as an aid to clinical decision‐making for an individual case, (d) assessment of a wound, with/without infection, and peripheral artery disease (assessment of perfusion and potential benefit from revascularisation), and (d) audit of outcome in local, regional, or national populations. We recommend: (a) for communication among health professionals the use of the SINBAD system (that includes Site, Ischaemia, Neuropathy, Bacterial Infection and Depth); (b) no existing classification for predicting outcome of an individual ulcer; (c) the Infectious Diseases Society of America/IWGDF (IDSA/IWGDF) classification for assessment of infection; (d) the WIfI (Wound, Ischemia, and foot Infection) system for the assessment of perfusion and the likely benefit of revascularisation; and (e) the SINBAD classification for the audit of outcome of populations.

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Reliability and Validity of the Perfusion, Extent, Depth, Infection and Sensation (PEDIS) Classification System and Score in Patients with Diabetic Foot Ulcer

Cited by 89 publications

References 23 publications

Ozone therapy for the treatment of chronic wounds: A systematic review

Ozone therapy for the treatment of chronic wounds: A systematic review

Risk factors for amputation in patients with diabetic foot infection: a prospective study

Guidelines on the classification of diabetic foot ulcers (IWGDF 2019)

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